REALISTIC CHANGE BY C.H.O.I.C.E. @ WINCHESTER II (NPI# 1700167350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700167350 |
| Entity Type | Organization |
| Organization Name | REALISTIC CHANGE BY C.H.O.I.C.E. @ WINCHESTER II |
| Practice Address |
320 Winchester Rd Troutman NC 28166-9644 |
| Mailing Address |
Po Box 570 Troutman NC 28166-0570 |
| Practice Telephone | 7045282044 |
| Practice Fax Number | 7045282077 |
| Mailing Telephone | 7045282044 |
| Mailing Fax Number | 7045282077 |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2011-09-08 |
| Authorized Official Name | MRS. RHONDA CORPENING (CLINICAL DIRECTOR, C.E.O.) |
| Authorized Official Telephone | 7045282044 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL 049-132 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | EIN | 45239256 | 01 |
| Street Address |
320 WINCHESTER RD |
| City | TROUTMAN |
| State | NC |
| Zip Code | 28166-9644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518323 | Miracle Houses Inc | Community Based Residential Treatment Facility, Mental Illness | 320 Winchester Rd, Troutman, NC 28166-9644 | 2020-11-03 |
| 1861090706 | Miracle Houses, Inc. | Community/Behavioral Health | 320 Winchester Rd, Troutman, NC 28166-9644 | 2020-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156063 | Ebony N Wilson | Social Worker | 183 Iredell Ave, Troutman, NC 28166 | 2019-10-22 |
| 1588213573 | Kendall Troutman | Speech-Language Pathologist | 130 Oswalt Amity Rd, Troutman, NC 28166 | 2019-09-11 |
| 1487089561 | Stuart Elliott Tolman | Pharmacist | 408 Stillwater Lane, Troutman, NC 28166 | 2013-09-09 |
| 1558390476 | Troutman 1st Rx Pharmacy | Pharmacy | 106 Wagner Street, Troutman, NC 28166 | 2006-07-02 |
| 1114917309 | Lake Norman Medical Equipment | Durable Medical Equipment & Medical Supplies | 693 N Main St, Troutman, NC 28166 | 2005-10-27 |
| 1518457886 | Lauren Brannon | Registered Nurse | 154 S Main St, Troutman, NC 28166 | 2018-05-12 |
| 1568972123 | Denton Mow | Physician Assistant | 154 S Main St, Troutman, NC 28166 | 2017-10-09 |
| 1184659682 | Angelita C. Le Cras, Dds, Pa | Dentist | 204 South Main Street, Troutman, NC 28166 | 2006-07-12 |
| 1851326359 | Angelita Cleofe Lecras | Dentist | 204 South Main Street, Troutman, NC 28166 | 2006-07-12 |
| 1760955314 | Piedmont Healthcare, Pa | Family Medicine | 154 S Main St, Troutman, NC 28166-0200 | 2019-01-07 |
| Find all providers in zip 28166 | ||||
| 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 |
|---|---|---|---|---|
| 1801177084 | Realistic Change By C.h.o.i.c.e. @ Winchester I | Community Based Residential Treatment Facility, Mental Illness | 332 Winchester Rd, Troutman, NC 28166-9644 | 2011-09-01 |
| 1265713432 | Realistic Change By C.h.o.i.c.e., Inc. @ Valleybrook I | Community Based Residential Treatment Facility, Mental Illness | 245 Valleybrook Ln, Troutman, NC 28166-9645 | 2011-09-01 |
| 1003197278 | Realistic Change By C.h.o.i.c.e., Inc. @ Valleybrook II | Community Based Residential Treatment Facility, Mental Illness | 251 Valleybrook Ln, Troutman, NC 28166-9645 | 2011-09-01 |
| 1013518323 | Miracle Houses Inc | Community Based Residential Treatment Facility, Mental Illness | 320 Winchester Rd, Troutman, NC 28166-9644 | 2020-11-03 |
| 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 | ||||
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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.