UNITED RESIDENTIAL SERVICES OF N.C. (NPI# 1235276031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235276031 |
| Entity Type | Organization |
| Organization Name | UNITED RESIDENTIAL SERVICES OF N.C. |
| Practice Address |
6503 Kemper Ct Fayetteville NC 28303-2354 |
| Mailing Address |
Po Box 25928 Fayetteville NC 28314-5015 |
| Practice Telephone | 9105831104 |
| Practice Fax Number | 9106301104 |
| Mailing Telephone | 9105831104 |
| Mailing Fax Number | 9106301104 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2009-04-23 |
| Authorized Official Name | DARRIN LEE MCNEILL (FACILITY DIRECTOR) |
| Authorized Official Telephone | 9105831104 |
| 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 | 047-068 | NC | Residential Treatment Facilities |
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 026-694 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3418061 | 05 |
| Street Address |
6503 KEMPER CT |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28303-2354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801404496 | Matthew Pace | Physician Assistant | Bldg 5-4257 Bastogne St, Fort Bragg, NC 28303 | 2020-07-20 |
| 1952920449 | Vonetta Bethea Jackson | Social Worker | 391 Wagoner Drive, Fayetteville, NC 28303 | 2020-04-14 |
| 1932746229 | Julie Harriss | Specialist/Technologist | Bldg E 4062, Canopy Lane, Fort Bragg, NC 28303 | 2019-12-05 |
| 1235780354 | Helen Delores Johnson | Technician | 261 Pierron Dr, Fayetteville, NC 28303 | 2019-09-20 |
| 1922655075 | Andrea Margaret Hutnam | Technician | 714 Shortridge Rd, Fayetteville, NC 28303 | 2019-08-23 |
| 1225695273 | Breona Lister | Dental Hygienist | 38 17 Gruber Rd, Fort Bragg, NC 28303 | 2019-05-24 |
| 1780148957 | Brian K Cox Sr. | Occupational Therapy Assistant | 5300 Ramsey St, Fayetteville, NC 28303 | 2019-01-22 |
| 1730670902 | Michael Sadtler | Counselor | 804 Stamper Rd Ste 101, Fayetteville, NC 28303 | 2018-05-23 |
| 1104320399 | Tia Porterfield | Counselor | 2018 Fort Bragg Rd Ste 112a, Fayetteville, NC 28303 | 2018-03-21 |
| 1154835577 | Jessica Bass Bosworth | Psychologist | 3415 Youngstown Dr, Fayetteville, NC 28303 | 2017-11-21 |
| Find all providers in zip 28303 | ||||
| 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 |
|---|---|---|---|---|
| 1841612215 | Ravenwood | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 190 Bonney Ln, Fayetteville, NC 28306-3736 | 2014-01-20 |
| 1508288218 | Teresa Mcneill | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3608 Pickerel St, Fayetteville, NC 28306 | 2014-01-15 |
| 1750713921 | The Loving Home, Inc. #4 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1710 Scampton Dr, Fayetteville, NC 28303-3742 | 2013-07-30 |
| 1336580620 | Sophia B. Pierce & Associates, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1128 Paddington Pl, Fayetteville, NC 28314-6304 | 2013-07-15 |
| 1730457458 | Georgia Community Living Facilities LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 500 Lanier Ave W Ste 610, Fayetteville, GA 30214-7644 | 2011-12-08 |
| 1720398282 | Joyful Living Group Home #3 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2809 Eldorado Rd, Fayetteville, NC 28306-1916 | 2010-10-18 |
| 1518274695 | Cyshelle Williams | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4604 Pine Needle Ct, Fayetteville, NC 28314-2463 | 2010-09-09 |
| 1639322472 | Joyful Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6125 Louise St, Fayetteville, NC 28314-2720 | 2008-10-24 |
| 1326291246 | Joyful Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1951 Ireland Dr, Fayetteville, NC 28304-1504 | 2008-10-23 |
| 1366699415 | Stepping Stones Group Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1446 Pamalee Drive, Fayetteville, NC 28303 | 2008-08-20 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28303 |
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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.