THE DOOR OF LIFE RESIDENTIAL SERVICES (NPI# 1265564314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265564314 |
| Entity Type | Organization |
| Organization Name | THE DOOR OF LIFE RESIDENTIAL SERVICES |
| Practice Address |
227 Constitution Way Cameron NC 28326-9296 |
| Mailing Address |
1504 Bramber Pl Conway SC 29527-3177 |
| Practice Telephone | 3364203195 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | MR. HARVEY W CAMPBELL (CEO) |
| Authorized Official Telephone | 3364203195 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL043069 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285826503 | The Door of Life Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 227 Constitution Way, Cameron, NC 28326-9296 | 2007-08-10 |
| Street Address |
227 CONSTITUTION WAY |
| City | CAMERON |
| State | NC |
| Zip Code | 28326-9296 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285826503 | The Door of Life Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 227 Constitution Way, Cameron, NC 28326-9296 | 2007-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447879903 | Christapher Frank | Nurse Practitioner | 2034 Wesvill Court, Suite 320, Raleigh, NC 28326 | 2020-04-14 |
| 1649825308 | Marisol Lopez | Dentist | 468 Nc Highway 24-87, Cameron, NC 28326 | 2019-08-08 |
| 1033676671 | Amanda Sue Vakos | Behavior Technician | 169 Mattie Haddock Dr, Cameron, NC 28326 | 2019-03-01 |
| 1518475607 | Mirinda Cossel | Assistant Behavior Analyst | 1477 Nc 87, Cameron, NC 28326 | 2018-01-11 |
| 1366961021 | Thomas Peper | Optometrist | 18 Biltmore Ln, Cameron, NC 28326 | 2017-09-13 |
| 1801312020 | Judith Lee Keeney | Behavioral Analyst | 185 Mittie Haddock Drive, Cameron, NC 28326 | 2017-08-18 |
| 1013455864 | Rita Mashburn | Pharmacist | 2800 Nc Hwy 24-87, Cameron, NC 28326 | 2017-02-01 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1699178897 | Buffalo Lake Medical Pllc | Physician Assistant | 181 Mittie Haddock, Cameron, NC 28326 | 2014-10-01 |
| 1629487137 | Raymond J. Tseng Dds, Phd, I, Pa | Dentist | 1520 Nc Highway 24/87, Cameron, NC 28326 | 2014-08-08 |
| Find all providers in zip 28326 | ||||
| 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 | ||||
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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.