POTTERS HOUSE OUTREACH CORPORATION (NPI# 1568552982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568552982 |
| Entity Type | Organization |
| Organization Name | POTTERS HOUSE OUTREACH CORPORATION |
| Practice Address |
105 Harvest Lane Raeford NC 28376 |
| Mailing Address |
Po Box 26073 Fayetteville NC 28314 |
| Practice Telephone | 9109041844 |
| Practice Fax Number | 9108677731 |
| Mailing Telephone | 9108677791 |
| Mailing Fax Number | 9108677731 |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. VINCENT TERREL ROBINSON (OWNER) |
| Authorized Official Telephone | 9108677791 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL047074 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603637 | 05 |
| Street Address |
105 HARVEST LANE |
| City | RAEFORD |
| State | NC |
| Zip Code | 28376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578185104 | Elite Supply Services, Inc. | Durable Medical Equipment & Medical Supplies | 2148 Bus-us 401, Raeford, NC 28376 | 2020-05-18 |
| 1205485695 | Brenda P Gregorio | Technician | 297 Gregorios Ln, Raeford, NC 28376 | 2019-09-09 |
| 1083197115 | Jennifer Picerno Bowyer | Nurse Practitioner | 929 Prospect Ave., Raeford, NC 28376 | 2018-09-14 |
| 1730694746 | Embassy Health Network | Counselor | 2148 Hwy 401 Business, Raeford, NC 28376 | 2017-12-13 |
| 1508398991 | Rockfish Pharmacy Inc | Pharmacy | 221 Flagstone Lane, Raeford, NC 28376 | 2017-04-03 |
| 1205281235 | William Fiebig | Nurse Practitioner | Hoke Hospital, 210 Medical Pavilion Drive, Raeford, NC 28376 | 2016-04-27 |
| 1306200647 | Tia Hart Community Recovery Program | Community/Behavioral Health | 2188 A Us 401 Business, Raeford, NC 28376 | 2016-04-13 |
| 1508240631 | Integrated Mental Health Services Agency Inc | Community/Behavioral Health | 2188-a Hwy 401 Business, Raeford, NC 28376 | 2015-07-18 |
| 1649658287 | Divine Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 320 Birch St, Raeford, NC 28376 | 2015-05-15 |
| 1992192298 | David Abdulhaqq | Counselor | 225 Aggies Lane, Raeford, NC 28376 | 2015-04-24 |
| Find all providers in zip 28376 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497902050 | The Rose House, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 670 Scurlock School Rd, Raeford, NC 28376-8698 | 2008-08-26 |
| 1568622009 | Potter's House Outreach Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 105 Harvest Ln, Raeford, NC 28376-6516 | 2008-06-09 |
| 1437379872 | Unlimitedcare Residential Facility | Residential Treatment Facility, Emotionally Disturbed Children | 120 Tanner Loop, Raeford, NC 28376-9278 | 2007-04-26 |
| 1760516488 | Mceachin Treatment Facility | Residential Treatment Facility, Emotionally Disturbed Children | 10218 Fayetteville Road, Raeford, NC 28376 | 2007-03-15 |
| 1366685968 | Hope Gardens Treatment Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1958 Turnpike Road, Raeford, NC 28376-8520 | 2009-04-13 |
| 1477610723 | Right Choices Community Care | Residential Treatment Facility, Emotionally Disturbed Children | 510 S Main St, Raeford, NC 28376-3225 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| 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.