Marc's Manor LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL065165 Issued in NC

Legal business name

MARC'S MANOR LLC

Practice address

3207 Reminisce Rd
Castle Hayne, NC 28429

Phone

(910) 675-7878

NPI assigned

Dec 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Terry Mims

Title

Owner

Phone

(910) 273-5838

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1962566182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 BROOKCROSSING DR",
            "address_2": "VILLAGE AT LAKEWOOD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069790",
            "telephone_number": "910-273-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 REMINISCE RD",
            "city": "CASTLE HAYNE",
            "state": "NC",
            "postal_code": "28429",
            "telephone_number": "910-675-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC'S MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-273-5838",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL065165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Castle Hayne, NC
• Providers in Castle Hayne, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.