SELF-DETERMINATION LLC


Address: 103 Ebenezer Rd, Kings Mtn, NC 28086
Phone: 7047504752

SELF-DETERMINATION LLC (NPI# 1639408248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639408248
Entity Type Organization
Organization Name SELF-DETERMINATION LLC
Practice Address 103 Ebenezer Rd
Kings Mtn
NC 28086
Mailing Address 103 Ebenezer Rd
Kings Mtn
NC 28086-8762
Practice Telephone 7047504752
Practice Fax Number 7047504753
Mailing Telephone 7047504752
Mailing Fax Number 7047504753
Enumeration Date 2009-12-09
Last Update Date 2018-08-10
Authorized Official Name FLOYDCE JEFFERIES (PRESIDENT)
Authorized Official Telephone 8284330465
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QD1600X Clinic/Center
Specialization: Developmental Disabilities
Ambulatory Health Care Facilities
N 320800000X Community Based Residential Treatment Facility, Mental Illness 023-197 NC Residential Treatment Facilities
N 251S00000X Community/Behavioral Health Agencies
N 320800000X Community Based Residential Treatment Facility, Mental Illness Residential Treatment Facilities
N 322D00000X Residential Treatment Facility, Emotionally Disturbed Children 012-129 NC Residential Treatment Facilities
Y 251B00000X Case Management Agencies

Other Provider Identifier

State Issuer Identifier Type Code
NC 6604454 05

Office Location

Street Address 103 EBENEZER RD
City KINGS MTN
State NC
Zip Code 28086

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1609252493 Mary Elizabeth Mann Speech-Language Pathologist 1563 Lewis Farm Rd, Kings Mountain, NC 28086 2015-08-04
1831404847 Sandra Shuford Satterfield Nurse Practitioner 500 Phifer Road, Kings Mountain, NC 28086 2010-08-13
1821317868 Crawley Memorial Hospital Inc Long Term Care Hospital 706 West King Street, Kings Mountain, NC 28086 2010-05-28
1770731515 Ingles Markets Inc Pharmacy 2111 Shelby Rd, Kings Mountain, NC 28086 2008-09-05
1659553832 Jerry Marvin Utt Social Worker 301 East Parker Street, Kings Mountain, NC 28086 2007-11-29
1518087766 Educare Community Living Corporation - North Carolina Community/Behavioral Health 112 Wooding Pl, Kings Mountain, NC 28086 2007-03-30
1093831679 Mark David Lovelace Pharmacist 1114 West Gold Street, Extension, Kings Mountain, NC 28086 2007-03-22
1417016023 Acrolyst Physician Resources Internal Medicine 827 E King Street, Kings Mountain, NC 28086 2006-12-08
1730248865 Kmeg Resource Corp Pa Internal Medicine 827 East King Street, Kings Mtn, NC 28086 2006-12-06
1649362526 William John Majors IIi Chiropractor 110 West King Street, Ste 2, Kings Mountain, NC 28086 2006-09-29
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Taxonomy Information

Taxonomy Code 251B00000X
Grouping Agencies
Classification Case Management

Taxonomy Definition

An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1316548084 Carolina Bridges Home Health Case Management 8410 Six Forks Rd Ste 104, Raleigh, NC 27615-3079 2020-11-07
1861008179 Maggie Janes LLC Case Management 3004 Hillmer Dr, Raleigh, NC 27609-7810 2020-09-22
1245846294 Tamekia Dowdy Case Management 845 Mckoy Town Rd, Cameron, NC 28326-9619 2020-09-16
1467067785 Knox Counseling and Consulting, PC Case Management 513 New Bridge St-suite 500, Jacksonville, NC 28540 2020-09-14
1700499944 Goal Digger Network LLC Case Management 5220 Delco St, Fayetteville, NC 28311-2332 2020-08-27
1598377731 Lux Glamorous Wigs & Company Case Management 1237 Tyvola Dr # Rd, Charlotte, NC 28210-3870 2020-08-19
1588275432 Green Life Enhancement Services Case Management 1220 Aragon Dr Apt 101, Knightdale, NC 27545-6027 2020-08-13
1629688122 Aketre Whitaker Case Management 526 Coker Town Rd, Whitakers, NC 27891-8942 2020-08-09
1912517046 Coastal Community Services, LLC Case Management 138 Turquoise Dr, Jacksonville, NC 28546-8757 2020-08-04
1700494903 Reimagine Billing Concepts LLC Case Management 9816 Cockerham Ln, Huntersville, NC 28078-2737 2020-07-14
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Competitor

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City KINGS MTN
Zip Code 28086

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Dataset Information

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.

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