JACKSONVILLE TREATMENT CENTER (NPI# 1750763942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750763942 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE TREATMENT CENTER |
| Practice Address |
806 Bell Fork Rd Jacksonville NC 28540-6312 |
| Practice Telephone | 9103472205 |
| Mailing Telephone | 9103472205 |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |
| Authorized Official Name | MR. TIMOTHY LAMONT GUNN (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 9103472205 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
MHL067166 | NC | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750821229 | Jacksonville Treatment Center | Clinic/Center | 1112 Silver Oaks Ct, Raleigh, NC 27614-9359 | 2017-03-03 |
| Street Address |
806 BELL FORK RD |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28540-6312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382408 | Antonia Evette Perkins | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2020-09-25 |
| 1710512868 | Breanna Tiffany Elliott | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2020-03-10 |
| 1871145953 | Shakira N Bell | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2019-07-10 |
| 1902458037 | Mary Alisa Bullock | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2019-07-09 |
| 1528531464 | Melissa Monique Graham | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2019-01-03 |
| 1982172045 | Chaka Mcknight | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2018-11-07 |
| 1255833299 | Catherine Veronica Jacobs | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2018-03-06 |
| 1760983589 | Susan Vega | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2018-02-27 |
| 1831604305 | Macy Melissa Hamm | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2017-12-06 |
| 1124539473 | Charlotte Ginyard | Counselor | 806 Bell Fork Rd, Jacksonville, NC 28540-6312 | 2017-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067785 | Knox Counseling and Consulting, PC | Case Management | 513 New Bridge St-suite 500, Jacksonville, NC 28540 | 2020-09-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1043782899 | Brice Rivra | Military Health Care Provider | Rr 612 Loop Road, Jacsksonvile, NC 28540 | 2018-12-18 |
| 1649768599 | Alexander John Pybus | Student in an Organized Health Care Education/Training Program | White St Bldg As-100, Jacksonville, NC 28540 | 2018-04-26 |
| 1881198182 | Orleiquis Guerra | Military Health Care Provider | Marine Corps Air Station New River Bldg As-100, Jacksonville, NC 28540 | 2018-03-21 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1588183198 | Citizen Community Transport, LLC | Private Vehicle | 220 Foxwood Ct., Jacksonville, NC 28540 | 2017-09-14 |
| 1558886242 | Brandon Jay Smith | Military Health Care Provider | E Street Bldg G770, Camp Lejeune, NC 28540 | 2017-08-03 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| Find all providers in zip 28540 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1326674995 | Cass County Mental Health Assoc | Clinic/Center | 60 E Central Park Plz, Jacksonville, IL 62650-2071 | 2020-03-16 |
| 1013401322 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650-2061 | 2018-06-20 |
| 1568970663 | Gateway Foundation, Inc. | Clinic/Center | 1300 Lincoln Ave, Jacksonville, IL 62650-3112 | 2018-01-11 |
| 1942724885 | Gateway Clinic, LLC | Clinic/Center | 7999 Philips Hwy, Suite 305, Jacksonville, FL 32256 | 2017-08-02 |
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|---|---|---|---|---|
| 1265047369 | The Blanchard Institute | Clinic/Center | 19902 N Cove Rd, Cornelius, NC 28031-6571 | 2020-09-15 |
| 1841816006 | Totten Therapeutic Services, Pllc | Clinic/Center | 5874 Faringdon Pl, Raleigh, NC 27609-3932 | 2020-06-23 |
| 1710527767 | New Leaf Center, LLC | Clinic/Center | 4195 W Us Highway 64 Ste 2, Murphy, NC 28906-8112 | 2020-01-07 |
| 1194372029 | Northstar Clinical Services | Clinic/Center | 322 Lamar Ave Ste 220, Charlotte, NC 28204-2436 | 2019-08-26 |
| 1679041362 | Oasis Recovery Centers, Inc | Clinic/Center | 191 Charlotte St # 200, Asheville, NC 28801-1938 | 2018-11-11 |
| 1225503527 | Recovery Center of North Carolina, LLC | Clinic/Center | 1806 N Aspen St, Lincolnton, NC 28092-6303 | 2018-10-12 |
| 1538648944 | Morehead City Treatment Center, LLC | Clinic/Center | 403 N 35th St, Morehead City, NC 28557-3107 | 2018-08-08 |
| 1548757438 | Mountainview Recovery, Inc | Clinic/Center | 108 Monticello Rd Ste 400, Weaverville, NC 28787 | 2018-04-17 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1093226110 | Promises12 Ltd LLC | Clinic/Center | 35 Means Ave Se, Concord, NC 28025-3563 | 2017-10-16 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 28540 |
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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.