MAGNANIMOUS GROUP HOME LLC (NPI# 1003047069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003047069 |
| Entity Type | Organization |
| Organization Name | MAGNANIMOUS GROUP HOME LLC |
| Practice Address |
9407 Hwy 41 W Pink Hill NC 28572-7021 |
| Practice Telephone | 9103243276 |
| Mailing Telephone | 9103243276 |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |
| Authorized Official Name | ISAIAH JOHNSON (CEO) |
| Authorized Official Telephone | 9103829985 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL-052-016 | NC | Residential Treatment Facilities |
| Street Address |
9407 HWY 41 W |
| City | PINK HILL |
| State | NC |
| Zip Code | 28572-7021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992803027 | Southerm Medical and Equipment Sales, L.p. | Durable Medical Equipment & Medical Supplies | 4459 Tarheel Drive, Suite D, Pink Hill, NC 28572 | 2006-09-20 |
| 1598785610 | Michael Gregg Wiggins Jr. | Pharmacist | 107 West Broadway Street, Pink Hill, NC 28572 | 2006-07-20 |
| 1194700799 | Edwin P Little | Family Medicine | 103 S Central Ave, Pink Hill, NC 28572 | 2005-12-07 |
| 1063505774 | Ricetta Rx North Carolina LLC | Pharmacy | 4459 Tarheel Drive, Pink Hill, NC 28572 | 2006-10-02 |
| 1912934845 | Tar Heel Health Care Services, LLC | Home Health | 206 S Turner St, Pink Hill, NC 28572-7880 | 2006-06-27 |
| 1215995873 | Pink Hill Chiropractic, Pa | Chiropractor | 312 W Broadway St, Pink Hill, NC 28572-7986 | 2006-05-03 |
| 1013965938 | Jennifer Trachte Murphy | Chiropractor | 312 W Broadway St, Pink Hill, NC 28572-7986 | 2006-05-04 |
| 1164672093 | Realo Discount Drug Stores of Pink Hill, Inc. | Pharmacy | 107 W Broadway St, Pink Hill, NC 28572-7998 | 2008-09-29 |
| 1184722068 | Realo Discount Drug Stores of Pink Hill, Inc. | Pharmacy | 107 W Broadway St, Pink Hill, NC 28572-7998 | 2006-09-21 |
| 1154528602 | Chrystal Turner Rooks | Dentist | 303 E Broadway St, Pink Hill, NC 28572-8045 | 2007-06-28 |
| Find all providers in zip 28572 | ||||
| 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 |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| Find all providers with the same taxonomy | ||||
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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.