EASON COURT GROUP HOME LLC #2 (NPI# 1003353475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003353475 |
| Entity Type | Organization |
| Organization Name | EASON COURT GROUP HOME LLC #2 |
| Practice Address |
124 Gregory Mnr Youngsville NC 27596-9614 |
| Mailing Address |
Po Box 759 Youngsville NC 27596-0759 |
| Practice Telephone | 9195565355 |
| Practice Fax Number | 8662858824 |
| Mailing Telephone | 9195565355 |
| Mailing Fax Number | 8662858824 |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |
| Authorized Official Name | SONJA DENISE WILLIAMS (ASSISTANT DIRECTOR) |
| Authorized Official Telephone | 5712884144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL 035 029 | NC | Residential Treatment Facilities |
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL 035 050 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7804575 | 05 |
| Street Address |
124 GREGORY MNR |
| City | YOUNGSVILLE |
| State | NC |
| Zip Code | 27596-9614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144879313 | Harp Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 12339 Wake Union Church Rd Ste 108, Wake Forest, NC 27596 | 2019-09-10 |
| 1326560806 | Nirali Patel | Pharmacist | 1190 Us Hwy 1n, Youngsville, NC 27596 | 2017-07-17 |
| 1790109577 | Riphen Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Blue Heron Drive, Youngsville, NC 27596 | 2014-02-13 |
| 1831524768 | Janice D Clark, Dds, Pa | Dentist | 680 Us Hwy 1 N, Suite 500, Youngsville, NC 27596 | 2013-09-11 |
| 1720372733 | Sherri Culbertson | Pharmacist | 1190 Us Hwy 1 North, Youngsville, NC 27596 | 2011-06-07 |
| 1326368390 | Trg Health Care Systems LLC | Social Worker | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2010-06-01 |
| 1932250065 | Catherine Grace Busam | Counselor | 90 Wheaton Dr, Youngsville, NC 27596 | 2007-01-16 |
| 1316022700 | Emmett Smoak Ackermon Jr. | Dentist | 66 Wheaton Ave, Youngsville, NC 27596 | 2006-10-26 |
| 1750323960 | Matthew Mullen | Specialist | 700 Us 1 Hwy Ste 100, Youngsville, NC 27596 | 2006-06-12 |
| 1992074314 | Trg Health Care Systems LLC | Community/Behavioral Health | 112 Wheaton Ave, Suite B, Youngsville, NC 27596 | 2011-12-14 |
| Find all providers in zip 27596 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1245837061 | Bliss Haven Group LLC | Community Based Residential Treatment Facility, Mental Illness | 2442 Sandhurst Ct, Gastonia, NC 28054-2738 | 2020-10-05 |
| 1386259265 | Nevaehs Caring Hands | Community Based Residential Treatment Facility, Mental Illness | 2509 Dalton Rd, Rocky Mount, NC 27803-4721 | 2020-09-09 |
| 1588279442 | C & C Homecare, LLC | Community Based Residential Treatment Facility, Mental Illness | 5119 Holdens Cross Rd, Wilson, NC 27893-8253 | 2020-09-08 |
| 1801409859 | Destiny & Miracle LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 Houston St, Gastonia, NC 28052-1632 | 2020-08-28 |
| 1699329433 | Fresh Start Today Inc | Community Based Residential Treatment Facility, Mental Illness | 3707 Roseheim Ct, Greensboro, NC 27405-4867 | 2019-07-30 |
| 1003460833 | Care-in-full | Community Based Residential Treatment Facility, Mental Illness | 1338 Sharp Ridge Rd, Greensboro, NC 27406-8597 | 2019-07-30 |
| 1366001976 | Foundation of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 119 Grice Road, Chadbourn, NC 28431-6709 | 2019-06-07 |
| 1558927590 | Tall Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1915 Hasty Rd, Marshville, NC 28103-0029 | 2019-05-15 |
| 1174187868 | Stepping Stone Services Inc. | Community Based Residential Treatment Facility, Mental Illness | 2720 White Oak Ln, Kannapolis, NC 28083-7256 | 2019-04-28 |
| Find all providers with the same taxonomy | ||||
| City | YOUNGSVILLE |
| Zip Code | 27596 |
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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.