SURRY-YADKIN RESIDENTIAL SERVICES, INC (NPI# 1861745069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861745069 |
| Entity Type | Organization |
| Organization Name | SURRY-YADKIN RESIDENTIAL SERVICES, INC |
| Practice Address |
1305 Park Dr Mount Airy NC 27030 |
| Mailing Address |
401 S Main St Suite 100 Mount Airy NC 27030-4700 |
| Practice Telephone | 3367896697 |
| Mailing Telephone | 3367190062 |
| Mailing Fax Number | 3367190064 |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2018-06-13 |
| Authorized Official Name | MR. JOSHUA DENNY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3367190062 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | MHL-086-020 | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 340609B | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 401 S Main St, Suite 100, Mount Airy, NC 270304700 | 3367190062 | 3367190064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528173069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 134 Sydnor St, Mount Airy, NC 27030 | 2006-08-21 |
| Street Address |
1305 PARK DR |
| City | MOUNT AIRY |
| State | NC |
| Zip Code | 27030 |
| 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 |
| 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 |
| 1912054750 | Joan Dolores Hudson | Counselor | Area Services and Programs, 351 Riverside Drive, Mount Airy, NC 27030 | 2007-01-04 |
| Find all providers in zip 27030 | ||||
| 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 |
|---|---|---|---|---|
| 1528173069 | Surry-yadkin Residential Services, Inc | Intermediate Care Facility, Mentally Retarded | 134 Sydnor St, Mount Airy, NC 27030 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730702937 | Gha Autism Supports | Intermediate Care Facility, Mentally Retarded | 44012 Morrow Mountain Rd, Albemarle, NC 28001-8616 | 2020-05-21 |
| 1811517774 | Educare Community Living Corporation-north Carolina | Intermediate Care Facility, Mentally Retarded | 834 Tyvola Rd Ste 116, Charlotte, NC 28217-3542 | 2020-04-21 |
| 1598125460 | Rha Health Services Nc LLC | Intermediate Care Facility, Mentally Retarded | 410 N Mineral Springs Rd, Durham, NC 27703-3618 | 2016-03-04 |
| 1023478294 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 619 Ray Ave, Hendersonville, NC 28792-2668 | 2016-03-02 |
| 1740649417 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 310 Locust Street, West Jefferson, NC 28694 | 2016-02-23 |
| 1841655453 | Journeys Healthcare | Intermediate Care Facility, Mentally Retarded | 515 Carver Moore Rd, Lake Waccamaw, NC 28450-9713 | 2015-12-24 |
| 1326414665 | Rha North Carolina Mr, Inc. | Intermediate Care Facility, Mentally Retarded | 1388 Lewis Fork Baptist Ch Rd, Ferguson, NC 28624-9080 | 2015-08-20 |
| 1609299916 | Rha Health Services Nc, LLC | Intermediate Care Facility, Mentally Retarded | 1802 Strickland Bridge Rd, Fayetteville, NC 28304-5739 | 2014-01-23 |
| 1861822314 | Voca Corporation of North Carolina | Intermediate Care Facility, Mentally Retarded | 4109 Enoch Dr, Charlotte, NC 28269-2578 | 2013-11-20 |
| 1902144314 | Rouse's Group Home Inc | Intermediate Care Facility, Mentally Retarded | 5820 Nc 135, Stoneville, NC 27048-8478 | 2013-01-18 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT AIRY |
| Zip Code | 27030 |
Please comment or provide details below to improve the information on SURRY-YADKIN RESIDENTIAL 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.