EDUCARE COMMUNITY LIVING CORPORATION-NORTH CAROLINA (NPI# 1811517774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811517774 |
| Entity Type | Organization |
| Organization Name | EDUCARE COMMUNITY LIVING CORPORATION-NORTH CAROLINA |
| Practice Address |
834 Tyvola Rd Ste 116 Charlotte NC 28217-3542 |
| Mailing Address |
805 N Whittington Pkwy Louisville KY 40222-5186 |
| Practice Telephone | 7045190007 |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |
| Authorized Official Name | ANGIE MATTINGLY (MANAGER-PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 5023813579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Community Alternatives North Carolina | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538374509 | Educare Community Living Corporation-north Carolina | Respite Care | 2420 Reliance Ave, Apex, NC 27539-7048 | 2007-05-13 |
| Street Address |
834 TYVOLA RD STE 116 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28217-3542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017798 | Kelby Rae Hurlocker | Specialist/Technologist | 500 Center Park Dr, Charlotte, NC 28217 | 2020-09-09 |
| 1356967749 | Optum Pharmacy 701, LLC | Pharmacy | 4015 Shopton Rd, Suite 600, Charlotte, NC 28217 | 2020-06-22 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1275016933 | Zarah Pulfrey | Physician Assistant | Womack Medical Center, 2817 Riley Road, Fort Bragg, NC 28217 | 2018-09-10 |
| 1972085918 | Dynamic Health Medical Group Pllc | Pain Medicine | 4705 South Blvd, Charlotte, NC 28217 | 2018-09-06 |
| 1184102048 | Charday Caple | Counselor | 735 Echodale Dr, Charlotte, NC 28217 | 2018-08-02 |
| 1326532250 | Dupont Livery LLC | Non-emergency Medical Transport (VAN) | 4200 S Tryon St, Charlotte, NC 28217 | 2018-06-14 |
| 1891215232 | Lakesha Shamise Welch | Counselor | 5709 South Hampton R., Charlotte, NC 28217 | 2017-06-27 |
| 1245768282 | Allison Harris Lafone | Counselor | 515 Clanton Road, Charlotte, NC 28217 | 2017-06-02 |
| 1619416906 | Charlie Randolph Taylor Jr. | Counselor | 517 Clanton Road, Charlotte, NC 28217 | 2017-02-20 |
| Find all providers in zip 28217 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861822314 | Voca Corporation of North Carolina | Intermediate Care Facility, Mentally Retarded | 4109 Enoch Dr, Charlotte, NC 28269-2578 | 2013-11-20 |
| 1770827552 | Educare Community Living Corporation - North Carolina | Intermediate Care Facility, Mentally Retarded | 8205 Browne Rd., Charlotte, NC 28217 | 2012-11-19 |
| 1063764702 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 5917 Rowan Way, Charlotte, NC 28214 | 2012-10-04 |
| 1972854693 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 4319 Mantle Ct, Charlotte, NC 28205-7243 | 2012-09-20 |
| 1093066714 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 4400 Dalmoor Dr, Charlotte, NC 28212-2157 | 2012-09-20 |
| 1043561764 | Autism Services of Mecklenburg County, Inc. | Intermediate Care Facility, Mentally Retarded | 1123 Ravendale Dr, Charlotte, NC 28216-1526 | 2012-09-20 |
| 1255451233 | Voca Corporation of North Carolina, Inc. | Intermediate Care Facility, Mentally Retarded | 5416 Oak Dr, Charlotte, NC 28216-2645 | 2007-03-31 |
| 1972623957 | Voca Corporation of North Carolina, Inc. | Intermediate Care Facility, Mentally Retarded | 1615 Purser Dr, Charlotte, NC 28215-2934 | 2007-03-31 |
| 1598885584 | Voca Corporation of North Carolina, Inc. | Intermediate Care Facility, Mentally Retarded | 2103 Wilson Ave, Charlotte, NC 28208-4655 | 2007-03-31 |
| 1902926983 | Voca Corporation of North Carolina, Inc. | Intermediate Care Facility, Mentally Retarded | 3017 Simpson Dr, Charlotte, NC 28205-2562 | 2007-03-31 |
| Find all providers in CHARLOTTE | ||||
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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.