JACKSON FAMILY CARE HOME II (NPI# 1588808240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588808240 |
| Entity Type | Organization |
| Organization Name | JACKSON FAMILY CARE HOME II |
| Practice Address |
7112 Outrigger Dr Wendell NC 27591-7240 |
| Mailing Address |
5641 Quail Covey Ln Wendell NC 27591-7901 |
| Practice Telephone | 9193661513 |
| Practice Fax Number | 9193661513 |
| Mailing Telephone | 9192665291 |
| Mailing Fax Number | 9192667901 |
| Enumeration Date | 2009-04-26 |
| Last Update Date | 2009-04-26 |
| Authorized Official Name | MRS. MARY MCCULLERS JACKSON (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 9192665291 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
FCL092148 | NC | Ambulatory Health Care Facilities |
| Street Address |
7112 OUTRIGGER DR |
| City | WENDELL |
| State | NC |
| Zip Code | 27591-7240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255752085 | Crandell's Enterprises Inc | Counselor | 7112 Outrigger Dr, Wendell, NC 27591-7240 | 2013-12-20 |
| 1295083467 | Bakers Family Care Home #2 | Custodial Care Facility | 7112 Outrigger Dr, Wendell, NC 27591-7240 | 2012-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063054872 | Monarch | Community/Behavioral Health | 1245 Hawks Perch Way, Wendell, NC 27591 | 2019-10-14 |
| 1922500792 | New Stone Helath Group Inc | Nurse Practitioner | 7408 Seimans Dr, Wendell, NC 27591 | 2018-03-07 |
| 1801235635 | Altruist Home Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 120 Mangums Drive, Wendell, NC 27591 | 2013-06-14 |
| 1902118243 | Rsi Medical Family Practice | Non-Pharmacy Dispensing Site | 2600 Hwy 97, Wendell, NC 27591 | 2010-07-01 |
| 1366618514 | Merlin W Young Dds Pa | Dentist | 3111 Wendell Blvd, Wendell, NC 27591 | 2008-05-07 |
| 1548449366 | Betty Maria Culver | Custodial Care Facility | 7309 Hunt Valley Trail, Wendell, NC 27591 | 2007-10-29 |
| 1639364227 | Wendell Medical Center Pa | Family Medicine | 217 Cook Street, Wendell, NC 27591 | 2007-09-07 |
| 1508982695 | Hollybrook Care Facility | Custodial Care Facility | 130 Harris Street, Wendell, NC 27591 | 2007-03-21 |
| 1528138443 | Merlin W Young | Dentist | 3111 Wendell Boulevard, Wendell, NC 27591 | 2006-11-08 |
| 1366525149 | Vardy Chiropractic and Wellness Clinics | Massage Therapist | 2825 Wendell Blvd., Wendell, NC 27591 | 2006-10-23 |
| Find all providers in zip 27591 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537436 | Amazing Love | Clinic/Center | 1201 W Crowell St, Monroe, NC 28112-4535 | 2020-10-27 |
| 1629677547 | Julia Kaplinska, Phd, Pllc | Clinic/Center | 4908 Vistawood Way, Durham, NC 27713-8065 | 2020-10-21 |
| 1013514587 | Lisa Johnson Reid | Clinic/Center | 3491 Evans St Ste B, Greenville, NC 27834-4534 | 2020-10-07 |
| 1609473230 | Chadwick Counseling, Pllc | Clinic/Center | 105 Chelsea Cir, Beaufort, NC 28516-9001 | 2020-10-06 |
| 1275146946 | Lakeisha Ward | Clinic/Center | 2221 W Raleigh Blvd Ste 117, Rocky Mount, NC 27803-2745 | 2020-08-24 |
| 1417570995 | Sb Psychiatry Pllc | Clinic/Center | 55 Vilcom Center Dr Ste 230, Chapel Hill, NC 27514-1690 | 2020-05-19 |
| 1467082396 | Premier Service of Carolina, Inc | Clinic/Center | 2020 Remount Rd Ste 105, Gastonia, NC 28054-7478 | 2020-01-20 |
| 1417598962 | Limitless Living Counseling & Consulting, Pllc | Clinic/Center | 806 Fairmont St, Greensboro, NC 27401-1723 | 2019-10-07 |
| 1598316770 | Renaissance Healthcare Group Raleigh, LLC | Clinic/Center | 7300 Carmel Executive Park Dr Ste 100, Charlotte, NC 28226-1307 | 2019-09-27 |
| 1255981627 | Each One Teach Two | Clinic/Center | 401 Hawthorne Ln Ste 110-224, Charlotte, NC 28204-2484 | 2019-09-17 |
| 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.