Meadows Place, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

MEADOWS PLACE, LLC

Practice address

8224 Lowell Valley Dr
Bahama, NC 27503-9775

Phone

(919) 477-3120

Fax

(919) 471-1460

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Frederick Darryl Williams

Title

Ceo

Phone

(919) 632-1105

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972649895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8224 LOWELL VALLEY DR",
            "city": "BAHAMA",
            "state": "NC",
            "postal_code": "275039775",
            "telephone_number": "919-477-3120",
            "fax_number": "919-471-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8224 LOWELL VALLEY DR",
            "city": "BAHAMA",
            "state": "NC",
            "postal_code": "275039775",
            "telephone_number": "919-477-3120",
            "fax_number": "919-471-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWS PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "DARRYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-632-1105",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603863",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Bahama, NC
• Providers in Bahama, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.