PEACE OF MIND RESIDENTIAL AND COMMUNITY SERVICES INC (NPI# 1730236274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730236274 |
| Entity Type | Organization |
| Organization Name | PEACE OF MIND RESIDENTIAL AND COMMUNITY SERVICES INC |
| Practice Address |
809 W 3rd St Pembroke NC 28372-7173 |
| Mailing Address |
Po Box 235 Fairmont NC 28340-0235 |
| Practice Telephone | 9105210588 |
| Practice Fax Number | 9105212267 |
| Mailing Telephone | 9107341697 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2008-01-10 |
| Authorized Official Name | MR. CHARLES K. ROBBINS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9106280039 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 385H00000X | Respite Care | NC | Respite Care Facility | |
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL078129 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3409520 | 05 |
| Street Address |
809 W 3RD ST |
| City | PEMBROKE |
| State | NC |
| Zip Code | 28372-7173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962977 | Kayla J Oxendine | Counselor | 86 Threehunts Drive, Pembroke, NC 28372 | 2020-11-03 |
| 1720688401 | Melissa Claire Kratz | Pharmacist | 930 Hwy 711 East, Pembroke, NC 28372 | 2020-10-30 |
| 1841775681 | Nikki Locklear | Counselor | 86 Three Hunts Dr., Pembroke, NC 28372 | 2018-09-27 |
| 1043703218 | Julie Anne Harrison-swartz | Nurse Practitioner | Uncp Student Health, 113 Hawk Drive, Pembroke, NC 28372 | 2018-06-12 |
| 1134627508 | William Dixon | Specialist/Technologist | One University Drive, Pembroke, NC 28372 | 2018-01-31 |
| 1740796291 | A Primary Choice, Inc. | In Home Supportive Care | 208 Union Chapel Road, Suite D, Pembroke, NC 28372 | 2017-12-20 |
| 1578924130 | William Joshua Johnson | Nurse Practitioner | 3334 Moss Neck Road, Pembroke, NC 28372 | 2016-03-10 |
| 1831560234 | Sungjun Jung | Pharmacist | 930 Nc Hwy 711 E, Pembroke, NC 28372 | 2015-10-12 |
| 1154715027 | Lilly Marie Shorter | Counselor | 86 Three Hunt Drive, Pembroke, NC 28372 | 2015-03-27 |
| 1487046728 | Eye Heart You Home Health, LLC | Public Health or Welfare | 925 University Road, Pembroke, NC 28372 | 2015-02-24 |
| Find all providers in zip 28372 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134275001 | Linda E Ashby | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 284 E River Rd, Pembroke, ME 04666-4408 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160552 | Residential Option Serving Adolescents, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2316 Carved Tree Ln, Charlotte, NC 28262-3154 | 2020-10-03 |
| 1649895442 | Gaynelle Bolling | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 Mandarin Dr, Pikeville, NC 27863-0020 | 2020-06-08 |
| 1851913966 | Johnson Enrichment Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 221 Foxcroft Dr, Winston Salem, NC 27103-5313 | 2020-05-12 |
| 1881230795 | Walter Jason Young Jr. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 412 Rook Rd, Charlotte, NC 28216-3199 | 2019-11-26 |
| 1750935839 | Heavenly Touch Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4720 Baileys Lake Rd Nw Apt 204, Concord, NC 28027-8576 | 2019-07-28 |
| 1073166245 | Making Kids Matter, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 409 Hunton Forest Dr Nw, Concord, NC 28027-0186 | 2019-07-17 |
| 1891357752 | New Hope for Tomorrow LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 528 Baldwin Rd, Burlington, NC 27217-1702 | 2019-07-01 |
| 1114490877 | Brenda Gail Cannon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3105 Vico Ter, Raleigh, NC 27610-5951 | 2019-01-05 |
| 1356813455 | Lamesha Marshall | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3335 Avalon Ave, Charlotte, NC 28208-3378 | 2018-12-31 |
| 1487131074 | Ronald Anthony Benjamin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1594 Candace Ridge Dr, Greensboro, NC 27406-8595 | 2018-07-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PEACE OF MIND RESIDENTIAL AND COMMUNITY SERVICES INC.
| 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.