MALACHI BEHAVIORAL HEALTHCARE,INC (NPI# 1508006479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508006479 |
| Entity Type | Organization |
| Organization Name | MALACHI BEHAVIORAL HEALTHCARE,INC |
| Practice Address |
200 Valencia Dr Suite 102&103 Jacksonville NC 28546-6311 |
| Practice Telephone | 9103537600 |
| Practice Fax Number | 9103537603 |
| Mailing Telephone | 9103537600 |
| Mailing Fax Number | 9103537603 |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2009-03-04 |
| Authorized Official Name | MS. SHANNETTE MONIQUE GRAY (OWNER) |
| Authorized Official Telephone | 9103537600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
NC | Respite Care Facility |
| Street Address |
200 VALENCIA DR SUITE 102&103 |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982688180 | Judith Tart Kettner | Counselor | 200 Valencia Dr, Suite 109, Jacksonville, NC 28546-7356 | 2005-12-01 |
| 1154797033 | Alpha Neurobehavioral Clinic | Counselor | 200 Valencia Dr, Suite 194, Jacksonville, NC 28546-6311 | 2015-08-14 |
| 1730584244 | Refuge Counseling & Consulting Services | Community/Behavioral Health | 200 Valencia Dr, Jacksonville, NC 28546-6311 | 2014-10-27 |
| 1649514605 | Brigita Sunshyne Baumgardner Lcsw Pa | Social Worker | 200 Valencia Dr, Suite 101, Jacksonville, NC 28546-6311 | 2012-11-15 |
| 1184900805 | Wilmina Beaumont Rosario | Counselor | 200 Valencia Dr, Jacksonville, NC 28546-6311 | 2011-10-26 |
| 1699050971 | Golden Gates Homecare Agency, LLC | In Home Supportive Care | 200 Valencia Dr, Suite 165, Jacksonville, NC 28546-6311 | 2011-10-18 |
| 1235417213 | Veronica Weaver | Counselor | 200 Valencia Dr, Suite 161, Jacksonville, NC 28546-6311 | 2011-07-25 |
| 1528353729 | Coastal Neurotherapy, P.a. | Clinical Neuropsychologist | 200 Valencia Dr, Suite 109, Jacksonville, NC 28546-6311 | 2011-06-15 |
| 1437451747 | Michelina H Therrien Lcsw Pa | Social Worker | 200 Valencia Dr, Suite 101, Jacksonville, NC 28546-6311 | 2010-11-19 |
| 1477863355 | Malachi Home Care,inc | Nursing Facility/Intermediate Care Facility | 200 Valencia Dr, Suite 103, Jacksonville, NC 28546-6311 | 2010-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 385HR2060X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental retardation and/or developmental disabilities as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578069209 | Lacendia Mitchell | Respite Care | 11036 Lydia Estates Dr W, Jacksonville, FL 32218-6937 | 2018-04-02 |
| 1205335619 | Annetta Aileen Brown | Respite Care | 4901 Sunbeam Rd Apt 1016, Jacksonville, FL 32257 | 2018-02-12 |
| 1417124892 | Katrina Lefaye James | Respite Care | 3504 North Davis Street, Jacksonville, FL 32209-4456 | 2008-05-14 |
| 1134687130 | Garden Heals Inc | Respite Care | 193 Bradford Lake Cir, Jacksonville, FL 32218-0103 | 2019-03-08 |
| 1750875977 | Future Sixcess Assisted Living Facility, LLC | Respite Care | 11036 Lydia Estates Dr W, Jacksonville, FL 32218-6937 | 2018-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1932502226 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 127 Daneborg Rd, Durham, NC 27703-9490 | 2014-10-01 |
| 1952702920 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 1840 Tyne Cir, Apt. 7103, Raleigh, NC 27607-6059 | 2014-09-10 |
| 1366843278 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 15 Toms Rock Pl, Durham, NC 27704-3878 | 2014-09-10 |
| 1356742266 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 910 Holloway St, Durham, NC 27701-3857 | 2014-09-10 |
| 1609277516 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 4021 Bella Park Trl, Apt. 234, Raleigh, NC 27613-7096 | 2014-09-10 |
| 1659783447 | Terrean Mcnair | Respite Care | 791 Crenshaw Rd, Saint Pauls, NC 28384-8488 | 2014-05-28 |
| 1851710396 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 308 Pebblestone Dr, Durham, NC 27703-6332 | 2014-04-14 |
| 1629494406 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 1315 Ripley St, Apt. B, Durham, NC 27707-1181 | 2014-03-17 |
| 1700202595 | Caring Hands and Supplementary Enrichment Education, LLC | Respite Care | 409 Tighfield Dr, Mebane, NC 27302-7422 | 2014-03-17 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on MALACHI BEHAVIORAL HEALTHCARE,INC.
| 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.