DIYAH'S HOME INC. (NPI# 1184649915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184649915 |
| Entity Type | Organization |
| Organization Name | DIYAH'S HOME INC. |
| Practice Address |
295 Appaloosa Dr Spring Lake NC 28390-8503 |
| Practice Telephone | 9104978599 |
| Practice Fax Number | 9104365928 |
| Mailing Telephone | 9104978599 |
| Mailing Fax Number | 9104365928 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID OMAR HAQQ (DIRECTOR) |
| Authorized Official Telephone | 9109788599 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-026-583 | NC | Residential Treatment Facilities |
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-043-045 | NC | Residential Treatment Facilities |
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-043-056 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603538 | 05 | |
| NC | 6603270 | 05 | |
| NC | 6603854 | 05 |
| Street Address |
295 APPALOOSA DR |
| City | SPRING LAKE |
| State | NC |
| Zip Code | 28390-8503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296208 | Morgan Lubawski | Behavior Technician | 1018 N Bragg Blvd Suite A, Spring Lake, NC 28390 | 2019-10-14 |
| 1285281451 | Cassandra Lynetta Burney | Nurse Practitioner | 104 Lake Ave, Spring Lake, Nc 28390, Spring Lake, NC 28390 | 2019-08-22 |
| 1861956500 | Victoria Denise Bland | Behavior Technician | 1018 N Bragg Blvd Ste A, Spring Lake, NC 28390 | 2019-01-28 |
| 1184102584 | Gregory Scott Seese | Psychologist | 1212 Micahs Way N, Spring Lake, NC 28390 | 2018-07-30 |
| 1174034052 | Danielle Nicole Lord | Specialist | 401 Lillington Hwy N 210, Spring Lake, NC 28390 | 2017-10-18 |
| 1205372588 | Interventional Pain Center, Pllc | Anesthesiology | 517 B Hwy 210 N, Spring Lake, NC 28390 | 2017-01-11 |
| 1699210690 | Rhea Lorena Jimenez | Nurse Practitioner | 517b Hwy 210 N, Spring Lake, NC 28390 | 2016-12-29 |
| 1841641883 | Parise Exquisite | Prosthetic/Orthotic Supplier | 401 Nc-210, Spring Lake, NC 28390 | 2016-06-30 |
| 1083037444 | Dr. Vincent Vissichelli & Associates, D.m.d., P.a. | Dentist | 2980 Ray Road, Spring Lake, NC 28390 | 2014-01-21 |
| 1376820761 | Jamie Gilles | Pharmacist | 512 Villag Lake Court Apt # 201, Spring Lake, NC 28390 | 2011-11-14 |
| Find all providers in zip 28390 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558425850 | First Priority Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1419 Milton St, Spring Lake, NC 28390-2511 | 2006-12-20 |
| 1851694368 | Unity Home Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1419 Milton St, Spring Lake, NC 28390-2511 | 2010-12-06 |
| 1003055856 | Zion Development Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1419 Milton St, Spring Lake, NC 28390-2511 | 2009-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160552 | Residential Option Serving Adolescents, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2316 Carved Tree Ln, Charlotte, NC 28262-3154 | 2020-10-03 |
| 1649895442 | Gaynelle Bolling | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 Mandarin Dr, Pikeville, NC 27863-0020 | 2020-06-08 |
| 1851913966 | Johnson Enrichment Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 221 Foxcroft Dr, Winston Salem, NC 27103-5313 | 2020-05-12 |
| 1881230795 | Walter Jason Young Jr. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 412 Rook Rd, Charlotte, NC 28216-3199 | 2019-11-26 |
| 1750935839 | Heavenly Touch Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4720 Baileys Lake Rd Nw Apt 204, Concord, NC 28027-8576 | 2019-07-28 |
| 1073166245 | Making Kids Matter, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 409 Hunton Forest Dr Nw, Concord, NC 28027-0186 | 2019-07-17 |
| 1891357752 | New Hope for Tomorrow LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 528 Baldwin Rd, Burlington, NC 27217-1702 | 2019-07-01 |
| 1114490877 | Brenda Gail Cannon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3105 Vico Ter, Raleigh, NC 27610-5951 | 2019-01-05 |
| 1356813455 | Lamesha Marshall | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3335 Avalon Ave, Charlotte, NC 28208-3378 | 2018-12-31 |
| 1487131074 | Ronald Anthony Benjamin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1594 Candace Ridge Dr, Greensboro, NC 27406-8595 | 2018-07-26 |
| Find all providers with the same taxonomy | ||||
| City | SPRING LAKE |
| Zip Code | 28390 |
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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.