CAROLINA RESIDENTIAL SERVICES, INC. (NPI# 1740312198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740312198 |
| Entity Type | Organization |
| Organization Name | CAROLINA RESIDENTIAL SERVICES, INC. |
| Practice Address |
145 N Gilmer St Mount Airy NC 27030-3842 |
| Mailing Address |
Po Box 286 Rutherford College NC 28671-0286 |
| Practice Telephone | 3367864196 |
| Practice Fax Number | 3367864196 |
| Mailing Telephone | 8285722333 |
| Mailing Fax Number | 9802250500 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2013-07-20 |
| Authorized Official Name | MS. SUSAN M KINCAID (DIRECTOR) |
| Authorized Official Telephone | 8285722333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | MHL 086039 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7806598 | 05 | |
| NC | 7805083 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629343512 | Carolina Residential Services, Inc. | Community/Behavioral Health | 204 Avery Ave, Morganton, NC 28655-3103 | 2012-03-12 |
| 1619242518 | Carolina Residential Services, Inc. | Community/Behavioral Health | 714 Simmons St, Goldsboro, NC 27530-3843 | 2012-03-12 |
| 1982805933 | Carolina Residential Services, Inc. | Day Training, Developmentally Disabled Services | 126 Commercial Rd, Ahoskie, NC 27910-9469 | 2007-05-29 |
| 1770705956 | Carolina Residential Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 314 East Westbrook Street, Wallace, NC 28466-1533 | 2007-05-03 |
| 1265652754 | Carolina Residential Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2302 Lewis Thomas Rd, Asheboro, NC 27205-1501 | 2007-04-26 |
| 1235261686 | Carolina Residential Services, Inc. | Case Management | 504 E Union St, Morganton, NC 28655-3456 | 2007-03-12 |
| 1053443408 | Carolina Residential Services, Inc. | Case Management | 641 W Main Ave, Taylorsville, NC 28681-2327 | 2007-03-12 |
| 1144352691 | Carolina Residential Services, Inc. | Community/Behavioral Health | 1014 Hay St, Fayetteville, NC 28305-5316 | 2007-03-11 |
| 1427180975 | Carolina Residential Services, Inc. | Community/Behavioral Health | 130 Williams St, Boonville, NC 27011-9300 | 2007-03-11 |
| 1063544518 | Carolina Residential Services, Inc. | Community/Behavioral Health | 534 Elk Spur St, Elkin, NC 28621-3206 | 2007-03-11 |
| Street Address |
145 N GILMER ST |
| City | MOUNT AIRY |
| State | NC |
| Zip Code | 27030-3842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124475017 | Jeffrey Lynn Hunter | Podiatrist | 367 S Andy Griffith Pkwy # 200, Mount Airy, NC 27030 | 2016-05-20 |
| 1376984880 | Shari York | Counselor | 847 Westlake Dr, Mount Airy, NC 27030 | 2013-07-12 |
| 1861745069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 1305 Park Dr, Mount Airy, NC 27030 | 2012-10-25 |
| 1346592169 | Debra Lynn Campbell | Physician Assistant | 709 West Independence Blvd., Mount Airy, NC 27030 | 2012-10-03 |
| 1720217680 | Lena Anderson Ferris | Nurse Practitioner | 708 S South St Ste 400, Mount Airy, NC 27030 | 2009-07-13 |
| 1013104520 | Tong Li-masters | Internal Medicine | 830 Rockford Street, Winston Salem, NC 27030 | 2007-09-28 |
| 1336261528 | Thomas R Jackson Dds Pa | Dentist | 1007 Rockford Street, Mount Airy, NC 27030 | 2007-04-06 |
| 1467585422 | Ridgecrest Ritirement Community | Assisted Living Facility | Ridgecrest Retirement, LLC, 1000 Ridgecrest Ln., Mount Airy, NC 27030 | 2007-03-13 |
| 1568516755 | Lou Urmos | Family Medicine | 805 Merita Street, Mt Airy, NC 27030 | 2007-01-23 |
| 1568516391 | Mark Lee Appler | Internal Medicine | 708 S South St Ste 100, Mount Airy, NC 27030 | 2007-01-22 |
| Find all providers in zip 27030 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455126 | A Place 4 Me, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5305 Clearwater Lake Rd, Mount Holly, NC 28120-1445 | 2020-07-28 |
| 1922623792 | Our Home At Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4601 Waterford Knoll Dr Apt 1724, Charlotte, NC 28226-6015 | 2020-06-08 |
| 1922634484 | Tracey Holton | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Easterseals Ucp, 913 Carolina Ave N, Statesville, NC 28677 | 2020-03-17 |
| 1710443395 | Unity 4 Us Community Outreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 406 Lincoln St, Belmont, NC 28012-3045 | 2019-02-19 |
| 1871059444 | Believing Everyone Succeeds Together | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 323 Shady Grove Rd, Kings Mtn, NC 28086-9671 | 2019-02-19 |
| 1740744283 | Tri Plex Industries Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9635 Southern Pine Blvd Ste 154, Charlotte, NC 28273-5564 | 2019-01-29 |
| 1316415037 | Igr Collaborations | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 212 Pine Ridge Dr, Roanoke Rapids, NC 27870-6832 | 2018-11-12 |
| 1164924940 | David Douglas Whitfield | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5342 Us Highway 301 North, Micro, NC 27555 | 2018-03-07 |
| 1710489976 | Moravian Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 122 North Elm St., Suite 810, Greensboro, NC 27401 | 2018-03-05 |
| 1659897833 | Shelby Day Program | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 621 S Dekalb St Ste A, Shelby, NC 28150-6189 | 2017-08-18 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT AIRY |
| Zip Code | 27030 |
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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.