GOLDENBLUSH CIRCLE GROUP HOME (NPI# 1639336878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639336878 |
| Entity Type | Organization |
| Organization Name | GOLDENBLUSH CIRCLE GROUP HOME |
| Practice Address |
416 Mccullough Dr Suite 125 Charlotte NC 28262-4385 |
| Mailing Address |
6512 Goldenblush Cir Charlotte NC 28269-5102 |
| Practice Telephone | 7045471900 |
| Mailing Telephone | 7049489701 |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |
| Authorized Official Name | STEPHANIE CAHOON (BILLING SPECIALIST) |
| Authorized Official Telephone | 7049068893 |
| Is Organization Subpart | Y |
| Parent Organization Name | NEW LITE LIVING CHOICES,INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603994 | 05 |
| Street Address |
416 MCCULLOUGH DR SUITE 125 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-4385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629130877 | Mdfamily Medical Group, Pa | Pediatrics | 416 Mccullough Dr, Suite 140, Charlotte, NC 28262-4385 | 2006-12-14 |
| 1922660869 | Gilberto Antonio Lorenzana | Nurse Practitioner | 416 Mccullough Dr, Ste 110, Charlotte, NC 28262-4387 | 2019-07-01 |
| 1174997084 | Alicia Knotts | Registered Nurse | 416 Mccullough Dr, Ste 110, Charlotte, NC 28262-4385 | 2015-11-17 |
| 1346589744 | Step By Step Care, Inc | In Home Supportive Care | 416 Mccullough Dr, Ste 155, Charlotte, NC 28262-4385 | 2013-02-05 |
| 1558600171 | Step By Step Care Inc | In Home Supportive Care | 416 Mccullough Dr, Suite 155, Charlotte, NC 28262-4385 | 2013-02-01 |
| 1770735466 | North Charlotte Pediatrics Pllc | Pediatrics | 416 Mccullough Dr, Suite 416, Charlotte, NC 28262-4385 | 2008-10-14 |
| 1992988091 | Denise Ustik Hoffecker | Chiropractor | 416 Mccullough Dr, Suite 155, Charlotte, NC 28262-4385 | 2007-12-11 |
| 1235269606 | Christine Elizabeth Labins | Marriage & Family Therapist | 416 Mccullough Dr, Suite #235, Charlotte, NC 28262-4385 | 2007-03-06 |
| 1619002631 | Visions of Care | Counselor | 416 Mccullough Dr, Suite105, Charlotte, NC 28262-4385 | 2007-02-22 |
| 1942353172 | Caring Arms Youth and Family Services, Inc. | Counselor | 416 Mccullough Dr, Suite 130, Charlotte, NC 28262-4389 | 2007-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| 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 |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1457836736 | Miracle Houses, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7827 Kerry Brook Circle, Charlotte, NC 28214 | 2018-10-02 |
| 1306353248 | Families United | Community Based Residential Treatment Facility, Mental Illness | 6610 Harburn Forest Dr, Charlotte, NC 28269-6912 | 2017-12-31 |
| 1013466416 | Roha Solutions, Inc | Community Based Residential Treatment Facility, Mental Illness | 1529 Jennings St, Charlotte, NC 28216 | 2016-09-26 |
| 1104270636 | Dennis Griffin's Consulting | Community Based Residential Treatment Facility, Mental Illness | 4428 Staffordshire Ln, Charlotte, NC 28213-4238 | 2016-04-21 |
| 1336579077 | Growth and Wellness Center, LLC. | Community Based Residential Treatment Facility, Mental Illness | 12001 Olympic Club Dr, Charlotte, NC 28277-4057 | 2013-11-15 |
| 1912267477 | Between Faces Foundation, Inc | Community Based Residential Treatment Facility, Mental Illness | 13000 S Tryon St Ste F-179, Charlotte, NC 28278-7652 | 2012-05-17 |
| 1194084194 | Promising Youth & Adults Behavioral Healthcare, Inc | Community Based Residential Treatment Facility, Mental Illness | 2750 E Wt Harris Blvd Ste 105, Charlotte, NC 28213-4286 | 2012-05-10 |
| 1265747349 | Primary Care Solutions Inc | Community Based Residential Treatment Facility, Mental Illness | 6807 Idlewild Brook Ln, Charlotte, NC 28212-5858 | 2010-08-12 |
| 1902110828 | Primary Care Solutions Inc. | Community Based Residential Treatment Facility, Mental Illness | 2744 Fairstone Ave, Charlotte, NC 28269-5412 | 2010-08-03 |
| Find all providers in CHARLOTTE | ||||
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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.