SOPHIA B PIERCE & ASSOCIATES INC (NPI# 1699850891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699850891 |
| Entity Type | Organization |
| Organization Name | SOPHIA B PIERCE & ASSOCIATES INC |
| Other Organization Name | NORTHSIDE GROUP HOME |
| Practice Address |
3301 Barksdale Road Fayetteville NC 28301 |
| Mailing Address |
Po Box 2813 Fayetteville NC 28302 |
| Practice Telephone | 9108224455 |
| Practice Fax Number | 9108224455 |
| Mailing Telephone | 9108224455 |
| Mailing Fax Number | 9108224455 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2018-12-03 |
| Authorized Official Name | MRS. SOPHIA BLANKS PIERCE (EXECUTIVE DIRECTIVE) |
| Authorized Official Telephone | 9104888477 |
| Authorized Official Credential | EDD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | MHL026125 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3406042 | 05 |
| Other Name | Type Code |
|---|---|
| Northside Group Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720274509 | Sophia B Pierce & Associates Inc | Community/Behavioral Health | 1909 Stanberry Place, Fayetteville, NC 28301 | 2007-09-14 |
| 1699847541 | Sophia B Pierce & Associates Inc | Custodial Care Facility | 611 Country Club Drive, Fayetteville, NC 28301 | 2006-11-15 |
| 1750460952 | Sophia B Pierce & Associates Inc | Non-emergency Medical Transport (VAN) | 112 Royal Lane, Clinton, NC 28328 | 2006-11-06 |
| Street Address |
3301 BARKSDALE ROAD |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726219 | Jenna Michelle Odneal | Behavior Technician | 16915 Liverpool Pkwy. Suite B., Cornelius, NC 28301 | 2020-10-02 |
| 1790390094 | Jessica Shellman | Counselor | 408 Person St. Ste 103, Fayetteville, NC 28301 | 2020-09-14 |
| 1487205951 | Martha K Richardson | Technician | 720 Teachers Dr, Fayetteville, NC 28301 | 2019-09-25 |
| 1013568161 | Angela Rena Locklear | Counselor | 211 Lamon St, Fayeteville, NC 28301 | 2019-09-20 |
| 1619535747 | Teresa Wilson | Contractor | 1417 Canyionland Ct, Apt 209, Fayetteville, NC 28301 | 2019-06-04 |
| 1912461815 | Catherine Stevenson Nwogalanya | Community Health Worker | 1103 Hillsboro St., Fayetteville, NC 28301 | 2019-01-24 |
| 1811443187 | Michael Carroll | Counselor | 308 Peterson Place, Fayetteville, NC 28301 | 2016-08-28 |
| 1023499886 | Latifa Fedai | Nurse Practitioner | 380 Person Street, Fayettevill, NC 28301 | 2015-06-17 |
| 1265868939 | Aci Support Specialists | Community/Behavioral Health | 1725 Venna Drive, Fayetteville, NC 28301 | 2013-09-25 |
| 1871929547 | Aci Support Specialists | Day Training, Developmentally Disabled Services | 2820 Copenhagen Drive, Fayetteville, NC 28301 | 2013-09-25 |
| Find all providers in zip 28301 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609299916 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 1802 Strickland Bridge Rd, Fayetteville, NC 28304-5739 | 2014-01-23 |
| 1255574034 | Greater Image Healthcare, Corp | Intermediate Care Facility, Mentally Retarded | 401 Roberson Street, Fayetteville, NC 28301-5423 | 2009-04-09 |
| 1487799151 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 2001 Southern Ave, Fayetteville, NC 28306-1757 | 2007-02-21 |
| 1467597708 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 1818 Strickland Bridge Rd, Fayetteville, NC 28304-5739 | 2007-02-21 |
| 1912042797 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 800 Old Wilmington Rd, Fayetteville, NC 28301-6210 | 2007-02-20 |
| 1740337757 | Davis & Associates, Inc | Intermediate Care Facility, Mentally Retarded | 1108 Quailmeadow Dr, Fayetteville, NC 28314-5936 | 2007-01-04 |
| 1477634319 | Mid-state Health Systems, Inc | Intermediate Care Facility, Mentally Retarded | 4309 N.c. Hwy 87 S, Fayetteville, NC 28306-9818 | 2006-10-18 |
| 1023450723 | Mid-state Health Systems, Inc | Intermediate Care Facility, Mentally Retarded | 1050 Hogan St, Fayetteville, NC 28311-2340 | 2013-07-23 |
| 1083056782 | Mid-state Health Systems, Inc | Intermediate Care Facility, Mentally Retarded | 7559 Decatur Dr, Fayetteville, NC 28303-1989 | 2013-07-23 |
| 1922266816 | D & L Healthcare Services | Intermediate Care Facility, Mentally Retarded | 1108 Quailmeadow Dr, Fayetteville, NC 28314-5936 | 2008-05-28 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28301 |
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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.