THE DURHAM FAMILY GROUP HOME 'LODGE STREET HOUSE' (NPI# 1245374545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245374545 |
| Entity Type | Organization |
| Organization Name | THE DURHAM FAMILY GROUP HOME 'LODGE STREET HOUSE' |
| Practice Address |
203 Lodge St Durham NC 27707-2339 |
| Practice Telephone | 9196825375 |
| Practice Fax Number | 9196825375 |
| Mailing Telephone | 9196825375 |
| Mailing Fax Number | 9196825375 |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2007-08-28 |
| Authorized Official Name | MRS. SUSAN COX DURHAM (OWNER) |
| Authorized Official Telephone | 9197307405 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
MHL032393 | NC | Nursing & Custodial Care Facilities |
| Street Address |
203 LODGE ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27707-2339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538785928 | Ceara Smith | Social Worker | 1415 W Nc 54 Buidling 200, Suite 111, Durham, NC 27707 | 2020-06-22 |
| 1114554094 | Lauren Michelle Grosse | Physician Assistant | Fastmed Urgent Care 7010 Nc-751, Durham, NC 27707 | 2020-03-23 |
| 1386289635 | Ashley Bailey | Counselor | 1801 Fayetteville Street, Durham, NC 27707 | 2019-11-11 |
| 1881249886 | Erin Ramona Leger | Physical Therapist | 3706 Mayfair St, Ste 120, Durham, NC 27707 | 2019-08-06 |
| 1417417262 | Carmen Elisabeth Sanchez | Psychologist | 3326 Durham Chapel Hill Blvd Bldg D, Durham, NC 27707 | 2019-03-20 |
| 1477026144 | Pope Behavioral Health and Wellness | Counselor | 5102 Chapel Hill Durham Blvd., Suite 101, Durham, NC 27707 | 2019-01-06 |
| 1043780778 | Jessica Ann Revels | Counselor | 1415 West North Carolina 54, Building 100 Suite # 204, Durham, NC 27707 | 2018-11-26 |
| 1558830125 | Michael Brown | Counselor | 1502 W Nc-54, Suite 505, Durham, NC 27707 | 2018-11-13 |
| 1780152827 | Cassandra Gerwig Shaw | Registered Nurse | 5324 Mcfarland Dr Ste 310, Durham, NC 27707 | 2018-11-07 |
| 1942776232 | Lisa J Keskitalo | Physical Therapist | 3708 Mayfair St Ste 120, Durham, NC 27707 | 2018-10-15 |
| Find all providers in zip 27707 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609406578 | True Nobility Care, LLC | Assisted Living Facility | 206 S Bend Dr, Durham, NC 27713-6163 | 2020-01-20 |
| 1689870040 | Love and Care Family Care Home | Assisted Living Facility | 217 E Lawson St, Durham, NC 27707-3143 | 2007-06-22 |
| 1417153883 | Love and Care Family Care Home II | Assisted Living Facility | 1009 S Alston Ave, Durham, NC 27701-4407 | 2007-06-22 |
| 1730305277 | Haven Group Home #2 | Assisted Living Facility | 714 Arnette Ave, Durham, NC 27701-3105 | 2007-04-17 |
| 1437372737 | Don's Adult Care Group Home | Assisted Living Facility | 1925 Apex Highway, Durham, NC 27707-4243 | 2007-04-11 |
| 1063534535 | Donald E Browm | Assisted Living Facility | 1925 Nc Highway 55, Durham, NC 27707-4243 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265032320 | Healthy Moral Homes, LLC | Assisted Living Facility | 1513 Parks Village Rd, Zebulon, NC 27597-9580 | 2020-10-28 |
| 1578182556 | Connecting Dots Counseling Services | Assisted Living Facility | 2305 Woodbury Dr, Hillsborough, NC 27278-6620 | 2020-04-10 |
| 1629600770 | Safe Haven Facilities LLC | Assisted Living Facility | 412 Warren St, Williamston, NC 27892-2454 | 2020-02-06 |
| 1265998124 | Valerie Smith | Assisted Living Facility | 112 Shore Lake Dr Apt A, Greensboro, NC 27455-1452 | 2019-02-15 |
| 1376018895 | Abraham E Ketter | Assisted Living Facility | 4708 Twisted Oaks Rd Apt 104, Charlotte, NC 28212-7317 | 2018-10-11 |
| 1275014359 | Paris Washington | Assisted Living Facility | 3220 Atlas Dr, Charlotte, NC 28269-4193 | 2018-08-27 |
| 1396232195 | Southern Living for Seniors of Burnsville Nc LLC | Assisted Living Facility | 270 Love Fox Rd, Burnsville, NC 28714-9109 | 2018-04-17 |
| 1598123564 | Hills Dda Group Home | Assisted Living Facility | 2017 Eastridge Cir, Kinston, NC 28501-5224 | 2016-02-05 |
| 1013382811 | Joy and Devotion Family Services, Inc. | Assisted Living Facility | 5616 Old Garden Rd Apt 101, Wilmington, NC 28403-4435 | 2015-12-04 |
| 1831581289 | Duckworth Acquisitions LLC | Assisted Living Facility | 3341 Old Hwy 10 East, Nebo, NC 28761-6768 | 2015-02-23 |
| 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.