PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT) (NPI# 1003005240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003005240 |
| Entity Type | Organization |
| Organization Name | PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT) |
| Other Organization Name | DESTINY HOMES OF PHYD, INC. |
| Practice Address |
1611 Poole Rd Raleigh NC 27610-2658 |
| Mailing Address |
Po Box 20181 Raleigh NC 27619-0181 |
| Practice Telephone | 9197130035 |
| Practice Fax Number | 9197130034 |
| Mailing Telephone | 9196337800 |
| Mailing Fax Number | 9197130034 |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2009-03-26 |
| Authorized Official Name | MRS. ANDREA PRETTY (PRESIDENT) |
| Authorized Official Telephone | 9196337800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-092-491 | NC | Residential Treatment Facilities |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-092-537 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603862 | 05 | |
| NC | 6604280 | 05 |
| Other Name | Type Code |
|---|---|
| Destiny Homes of PHYD, Inc. | Doing Business As Name - Organization |
| Street Address |
1611 POOLE RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27610-2658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609499243 | Elizabeth Ranganai Mavindidze | Social Worker | Wakemed Health and Hospitals, 3000 New Bern Avenue, Raleigh, NC 27610 | 2020-05-18 |
| 1851958839 | Alex & Associates, P.C. | Dentist | 1600 Cross Link Road, Unit 103, Raleigh, NC 27610 | 2019-05-24 |
| 1639646367 | Carol Mary Medins | Dietitian, Registered | Wakemed Raleigh Medical Park, 23 Sunnybrook Road, Suite 200, Raleigh, NC 27610 | 2018-10-31 |
| 1144714601 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 123 Sunnybrook Rd Ste 150, Raleigh, NC 27610 | 2018-06-19 |
| 1417446006 | Eagles Eye Lab, Inc | Clinical Medical Laboratory | 4501 New Bern Ave, Ste: 130, Raleigh, NC 27610 | 2018-05-09 |
| 1316465206 | Jeffery King Neer | Social Worker | 3010 Falstaff Rd., C/o Unc Actt, Raleigh, NC 27610 | 2017-08-31 |
| 1083139885 | Kelsey Daniel Mccleave | Social Worker | 3630 Enduring Freedom Drive, Raleigh, NC 27610 | 2017-08-14 |
| 1891219093 | Tarheel Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4840 Quarryman Road, Raleigh, NC 27610 | 2017-07-29 |
| 1508214826 | Compassionate Care Providers LLC | Respite Care | 5110 Wetlands, Raleigh, NC 27610 | 2016-05-26 |
| 1730552530 | Matthew Belair | Pharmacist | 1601-51 Cross Link Rd, Raleigh, NC 27610 | 2015-11-03 |
| Find all providers in zip 27610 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598133209 | S.t.e.p. Up Behavioral Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 5809 N Beaver Ln, Raleigh, NC 27604-6057 | 2015-09-11 |
| 1033358825 | Chance Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1305 Hendren Cir, Raleigh, NC 27610-4937 | 2009-02-18 |
| 1386805984 | Carrington Children Family Services, L.l.c | Residential Treatment Facility, Emotionally Disturbed Children | 4401 Goldcrest Ln, Raleigh, NC 27616-8816 | 2008-06-17 |
| 1043409113 | Hope Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 8909 Sauls Rd, Raleigh, NC 27603-8726 | 2007-10-15 |
| 1992918627 | 2nd Chance Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 729 Kavkaz St, Raleigh, NC 27610-3174 | 2007-05-08 |
| 1639205701 | Gill House | Residential Treatment Facility, Emotionally Disturbed Children | 845 Cross Link Rd, Raleigh, NC 27610-4730 | 2007-02-26 |
| 1336274083 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3833 Buffaloe Rd, Raleigh, NC 27604-4210 | 2007-02-22 |
| 1669507315 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5817 Old Forge Cir, Raleigh, NC 27609-4035 | 2007-02-22 |
| 1851426431 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4928 Coolridge Ct Apt A, Raleigh, NC 27616-5294 | 2007-02-22 |
| 1255466827 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5039 Sedgewick Dr Apt D, Raleigh, NC 27616-4576 | 2007-02-22 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.