Stsdavisllc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

STSDAVISLLC

Practice address

431 Amhurst St SW
Concord, NC 28025-8838

Phone

(704) 890-6164

NPI assigned

Feb 16, 2024

Organization subpart

No

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

Authorized official

Name

Shannon Marie Davis

Title

Executive Director

Phone

(704) 890-6164

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1982469268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 AMHURST ST SW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280258838",
            "telephone_number": "704-890-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 AMHURST ST SW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280258838",
            "telephone_number": "704-890-6164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STSDAVISLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-890-6164"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Striker
• Stephanie L. Strollo, MD
• Erica Strong
• Roxanne Kathleen Stroud, NP
• Kayley Rebecca Strum, OT
• Ashley Stuart
• Lakale Tayforia Sturdivant, MA, LPC
• Suburban Guardianship, LLC.
• Jesse Sulzer, MD
• Lisa Ann Summers, MD

• Mental Illness Community Based Residential Treatment Facility in Concord, NC
• Providers in Concord, 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 May 1, 2024; 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.