CARILLON ASSISTED LIVING OF MINT HILL, LLC (NPI# 1376065003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376065003 |
| Entity Type | Organization |
| Organization Name | CARILLON ASSISTED LIVING OF MINT HILL, LLC |
| Practice Address |
5601 Margaret Wallace Road Matthews NC 28105 |
| Practice Telephone | (704) 573-4000 |
| Practice Fax Number | 7045734002 |
| Mailing Telephone | 7045734000 |
| Mailing Fax Number | 7045734002 |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2017-07-14 |
| Authorized Official Name | MS. KAREN E MORIARTY (PRESIDENT AND CEO) |
| Authorized Official Telephone | 9198524000 |
| Is Organization Subpart | Y |
| Parent Organization Name | CARILLON ASSISTED LIVING, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities |
| Street Address |
5601 MARGARET WALLACE ROAD |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| 1013395300 | South Charlotte Family Counseling | Counselor | 1214 Brightmoor Drive, Matthews, NC 28105 | 2015-05-07 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070215 | My Guardian Angel Family Care Home | Custodial Care Facility | 514 Cokey Road, Rocky Mount, NC 27801 | 2020-10-15 |
| 1932692159 | Carillon Assisted Living of Garner LLC | Custodial Care Facility | 200 Minglewood Dr, Garner, NC 27529-5273 | 2018-06-12 |
| 1821598335 | Sonya Waddell | Custodial Care Facility | 6025 Dustin Ridge Ct, Rural Hall, NC 27045-9011 | 2018-02-21 |
| 1518331669 | Carillon Assisted Living of Huntersville, LLC | Custodial Care Facility | 250 Commerce Center Dr, Huntersville, NC 28078 | 2015-11-30 |
| 1871961631 | Wake Forest Adult Day Care Inc | Custodial Care Facility | 3309 Rogers Rd, Suite 117, Wake Forest, NC 27587-3943 | 2015-09-10 |
| 1407238355 | Guardian Care Advisors, Inc. | Custodial Care Facility | 1320 Ashley Sq, Winston Salem, NC 27103-2919 | 2015-06-26 |
| 1275922171 | Freedom Ministries Church and Outreach | Custodial Care Facility | 539 Railway Place, Concord, NC 28025-0000 | 2015-01-15 |
| 1962803551 | Carillon Assisted Living of Clemmons, LLC | Custodial Care Facility | 1165 S Peace Haven Rd, Clemmons, NC 27012-8910 | 2014-09-15 |
| 1487062311 | Douglas Family Care | Custodial Care Facility | 1439 Us Highway 13 S, Ahoskie, NC 27910-8125 | 2014-07-23 |
| 1639585649 | Carillon Assisted Living of Wake Forest LLC | Custodial Care Facility | 3218 Heritage Trade Dr, Wake Forest, NC 27587-4238 | 2014-07-10 |
| 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.