SPECIAL JEWEL GROUP HOME (NPI# 1730319773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730319773 |
| Entity Type | Organization |
| Organization Name | SPECIAL JEWEL GROUP HOME |
| Practice Address |
200 S Tillery St Rocky Mount NC 27804-5527 |
| Mailing Address |
232 Regency Dr Nashville NC 27856-1812 |
| Practice Telephone | 2524466612 |
| Mailing Telephone | 2524466612 |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2009-07-24 |
| Authorized Official Name | ALICE CLARK (OWNER) |
| Authorized Official Telephone | 2524466612 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL064102 | NC | Residential Treatment Facilities |
| Street Address |
200 S TILLERY ST |
| City | ROCKY MOUNT |
| State | NC |
| Zip Code | 27804-5527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386010908 | Tillery's Place, LLC | Custodial Care Facility | 200 S Tillery St, Rocky Mount, NC 27804-5527 | 2015-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992288419 | Aubrey Kuester | Physical Therapist | Hunter Hills Nursing and Rehab, 7369 Hunter Hill Rd, Rocky Mount, NC 27804 | 2018-09-11 |
| 1134636475 | New Beginning Family Services of Nc | Clinic/Center | 600 Tiffany Blvd Ste H, Rocky Mount, NC 27804 | 2018-01-09 |
| 1033640776 | Simply Frazier Beauty Salon | Specialist | 1141 Jeffreys Rd, Rocky Mount, NC 27804 | 2017-03-24 |
| 1164961942 | Family Care Partners of North Carolina, Pllc | Internal Medicine | 1041 Noel Ln. Ste 105, Rocky Mt., NC 27804 | 2017-02-14 |
| 1164834867 | Ward Specialty Pharmacy LLC | Pharmacy | 3646 Sunset Ave, Suite 110 Barkley Square, Rocky Mount, NC 27804 | 2014-05-29 |
| 1891107678 | Patrick Ignacio | Pharmacist | 3646 Sunset Ave., Suite 110, Rocky Mount, NC 27804 | 2014-05-28 |
| 1023437795 | Down East Hearing | Hearing Aid Equipment | 1356 Benvenue Rd., Rocky Mount, NC 27804 | 2014-04-10 |
| 1659710416 | Sterling House of Rocky Mount | Assisted Living Facility | 650 Goldrock Road, Sterling House of Rocky Mount, Rocky Mount, NC 27804 | 2013-06-14 |
| 1700223609 | Keenya Anderson Staten | Nurse Practitioner | 1701 Sunset Ave Ste 105c, Rocky Mount, NC 27804 | 2013-05-31 |
| 1578844528 | Nathan Thomas Long | Pharmacist | 300 N Grace St Ste 150, Rocky Mount, NC 27804 | 2011-09-05 |
| Find all providers in zip 27804 | ||||
| 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 |
|---|---|---|---|---|
| 1316495369 | Guiding Star Health Care Two, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1564 Springbrook Dr, Rocky Mount, NC 27801-3562 | 2016-09-20 |
| 1629488044 | Williams Home Sweet Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1832 Springfield Rd, Rocky Mount, NC 27801-3060 | 2014-05-07 |
| 1962731463 | Daniels' Family Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1509 Charter Dr, Rocky Mount, NC 27801-3544 | 2009-12-11 |
| 1700114816 | Keaira's House Adult Group Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 836 Lincoln Dr, Rocky Mount, NC 27801-7456 | 2009-12-01 |
| 1902047095 | Rojae's Creation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 417 N Parker St, Rocky Mount, NC 27801-5871 | 2009-03-18 |
| 1093987737 | Edwards Enterprises Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1852 Old Wilson Rd, Rocky Mount, NC 27801-7461 | 2008-04-01 |
| 1376724039 | Brenda W Bryan | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2001 Vernon Rd, Rocky Mount, NC 27801 | 2007-11-21 |
| 1063691236 | Way Farer Court Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 145 Wayfarer Ct, Rocky Mount, NC 27801-6282 | 2007-10-24 |
| 1043409584 | Evergreen Road Facility | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 827 Evergreen Rd, Rocky Mount, NC 27803-2426 | 2007-10-22 |
| 1952465999 | Quality Development for Decisive People | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 736 Salisbury Dr, 736 Salisbury Dr, Rocky Mount, NC 27801-6133 | 2006-12-21 |
| Find all providers in ROCKY MOUNT | ||||
| City | ROCKY MOUNT |
| Zip Code | 27804 |
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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.