EDWARDS GROUP HOME 4 (NPI# 1609906288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609906288 |
| Entity Type | Organization |
| Organization Name | EDWARDS GROUP HOME 4 |
| Practice Address |
1269 Apple Tree Rd Stantonsburg NC 27883-9039 |
| Mailing Address |
Po Box 295 Snow Hill NC 28580-0295 |
| Practice Telephone | 2527474000 |
| Practice Fax Number | 2527472602 |
| Mailing Telephone | 2527474000 |
| Mailing Fax Number | 2527472602 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-01-10 |
| Authorized Official Name | THOMAS MCCOLLUM (CEO) |
| Authorized Official Telephone | 2527474000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL040027 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | PROVIDER NUMBER | 7805335 | 01 |
| Street Address |
1269 APPLE TREE RD |
| City | STANTONSBURG |
| State | NC |
| Zip Code | 27883-9039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770607384 | Virginia Dare Behavorial Health Services Inc. | Preferred Provider Organization | 367 Lane Road, Stantonsburg, NC 27883 | 2007-03-19 |
| 1518945732 | Mary A Clark | Nurse Practitioner | 312 South Main St, Stantonsburg, NC 27883 | 2006-01-06 |
| 1992782643 | Stantonsburg Drug Company, Inc | Pharmacy | 105 South Main Street, Stantonsburg, NC 27883-0040 | 2005-12-23 |
| 1730189119 | Armie Rowland Strickland Jr. | Pharmacist | 105 South Main St, Stantonsburg, NC 27883-0040 | 2005-07-27 |
| 1346396041 | Stantonsburg Drug Company, Inc | Durable Medical Equipment & Medical Supplies | 105 S Main St, Stantonsburg, NC 27883-0040 | 2007-01-26 |
| 1902932478 | Wilson Medical Center, Inc. | Family Medicine | 312 South Main Street, Stantonsburg, NC 27883-0400 | 2007-02-26 |
| 1356580088 | Carrie's Family Care Home | Custodial Care Facility | 1025 Pope Farm Rd, Stantonsburg, NC 27883-8525 | 2009-02-19 |
| 1225459308 | Easter Seals Ucp North Carolina & Virginia Inc. | Assisted Living Facility | 505 Hemphill St, Stantonsburg, NC 27883-9011 | 2013-12-17 |
| 1700418225 | Life, Inc. | Day Training, Developmentally Disabled Services | 505 Hemphill St, Stantonsburg, NC 27883-9011 | 2020-02-12 |
| 1831596535 | Circle of Love Family Care Home LLC. | Custodial Care Facility | 6604 Hwy 264 East Alt., Stantonsburg, NC 27883-9203 | 2014-11-24 |
| Find all providers in zip 27883 | ||||
| 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 |
|---|---|---|---|---|
| 1245360387 | Edwards Group Home 3 | Community Based Residential Treatment Facility, Mental Illness | 1233 Appletree Road, Stantonsburg, NC 27833 | 2007-03-07 |
| 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 | ||||
| City | STANTONSBURG |
| Zip Code | 27883 |
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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.