Innerchange Youth Homes LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL036260 Issued in NC

Legal business name

INNERCHANGE YOUTH HOMES LLC

Doing business as

Innerchange Youth Division 1

Practice address

724 Raindrops Rd
Gastonia, NC 28054-1779

Phone

(704) 884-0096

Fax

(704) 884-0097

NPI assigned

Sep 23, 2008

Last updated

Sep 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dina Catress Sawyer, B/S IN CRIMINAL JUST

Title

Owner/Director

Phone

(704) 458-1356

Specialties & licenses 1

Addresses

Other names 1

• Innerchange Youth Division 1 Doing business as

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1982854360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 36448",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282366448",
            "telephone_number": "704-884-0096",
            "fax_number": "704-884-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 RAINDROPS RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541779",
            "telephone_number": "704-884-0096",
            "fax_number": "704-884-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERCHANGE YOUTH HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "SAWYER",
        "authorized_official_first_name": "DINA",
        "authorized_official_middle_name": "CATRESS",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "704-458-1356",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B/S IN CRIMINAL JUST"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL036260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innerchange Youth Division 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Gastonia, NC
• Providers in Gastonia, 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 Sep 23, 2008; 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.