NPIMap

Organization Active NPI

Rockwell Development Center, Inc. - Stickney House

  • Mental Illness Community Based Residential Treatment Facility
  • Mooresville, NC
National Provider Identifier
1972650414
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL-049-098 Issued in NC
Legal business name
ROCKWELL DEVELOPMENT CENTER, INC. - STICKNEY HOUSE
Practice address
120 Rockwell Loop
Mooresville, NC 28115-9741
Phone
(704) 987-2096
Fax
(704) 987-2096
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Authorized official

Name
Ms. Lynn Ellen Oke, RN, BSN, MS, QP
Title
Chief Executive Officer
Phone
(704) 987-2096

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-049-098 NC Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-049-098 NC
Psychiatric Residential Treatment Facility 323P00000X MHL-049-098 NC

Addresses

Primary practice location

120 Rockwell Loop
Mooresville, NC 28115-9741

Mailing address

120 Rockwell Loop
Mooresville, NC 28115-9741
Phone (704) 987-2096

Other identifiers 1

IdentifierTypeStateIssuer
6603887MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Rockwell Development Center Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512604800000",
    "number": "1972650414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 ROCKWELL LOOP",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281159741",
            "telephone_number": "704-987-2096",
            "fax_number": "704-987-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ROCKWELL LOOP",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281159741",
            "telephone_number": "704-987-2096",
            "fax_number": "704-987-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKWELL DEVELOPMENT CENTER, INC. - STICKNEY HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2017-12-07",
        "status": "A",
        "authorized_official_last_name": "OKE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "704-987-2096",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, BSN, MS, QP"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-049-098",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-049-098",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NC",
            "license": "MHL-049-098",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603887",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; 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.