CLUB HORIZON, INC. (NPI# 1871657346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871657346 |
| Entity Type | Organization |
| Organization Name | CLUB HORIZON, INC. |
| Practice Address |
101b Forest Dr Knightdale NC 27545-9603 |
| Practice Telephone | 9192662202 |
| Mailing Telephone | 9192662202 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2008-10-21 |
| Authorized Official Name | MISS CARLISS MANAY GUNTER GUNTER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9192662202 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MHL 092613 | NC | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8301230B | 05 | |
| NC | 8301230S | 05 |
| Street Address |
101B FOREST DR |
| City | KNIGHTDALE |
| State | NC |
| Zip Code | 27545-9603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639688526 | Galberth Health | Physical Therapist | 8002 Peachtree Town Ln, Knightdale, NC 27545 | 2017-09-24 |
| 1790215390 | Edward Hoggard Jr. | Counselor | 2013 Ballston Place, Knightdale, NC 27545 | 2017-06-15 |
| 1730635970 | Tara Forsythe | Social Worker | 4006 Peachtree Town Lane, Knightdale, NC 27545 | 2016-08-28 |
| 1134504962 | Maybell Grino | Pharmacist | 7201 Us Highway 64, Knightdale, NC 27545 | 2015-07-22 |
| 1477948735 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 1408 Silver Valley Dr, Knightdale, NC 27545 | 2015-04-03 |
| 1235560772 | Shameka Latoya Davis | Counselor | 7417 Knightdale Blvd Unit 101, Knightdale, NC 27545 | 2013-12-10 |
| 1992135107 | Daniel Ross Conti | Dentist | 1001 Widewaters Parkway, Knightdale, NC 27545 | 2013-11-25 |
| 1255773644 | David D Sanjurjo | Nurse Practitioner | 7201 Us Hwy 64, Knightdale, NC 27545 | 2013-07-25 |
| 1790037133 | Dona D Mayo | Counselor | 502 Mcknight Drive, Better Communities, Knightdale, NC 27545 | 2012-10-09 |
| 1699972257 | Lindsay Horwat | Occupational Therapist | 1010 Emerald Common Drive, Apartment 205, Knightdale, NC 27545 | 2007-06-28 |
| Find all providers in zip 27545 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043843790 | Soul Restoration Counseling Services Pllc | Community/Behavioral Health | 101 Scott Ct, Knightdale, NC 27545-9508 | 2020-02-20 |
| 1790223931 | Community Angel Foundation | Community/Behavioral Health | 4011 Village Park Dr, Knightdale, NC 27545-7044 | 2017-02-08 |
| 1477948735 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 1408 Silver Valley Dr, Knightdale, NC 27545 | 2015-04-03 |
| 1649675539 | Universal Mental Health Services, Inc. | Community/Behavioral Health | 1010 Delta River Way, Knightdale, NC 27545-7326 | 2014-11-04 |
| 1598167595 | Q1 Clinical Consultants, LLC | Community/Behavioral Health | 201 Aqua Marine Ln, Knightdale, NC 27545-7869 | 2014-09-22 |
| 1982970331 | Change Awaits You, Pllc | Community/Behavioral Health | 7417 Knightdale Blvd, Suite 108, Knightdale, NC 27545-8824 | 2012-03-30 |
| 1508097528 | Victorious Healthcare Inc | Community/Behavioral Health | 7417 Knightdale Blvd Ste 108, Knightdale, NC 27545-8824 | 2009-08-07 |
| 1790913366 | Community Outreach Intense Family Services, LLC | Community/Behavioral Health | 1112 Hadel Pl, Knightdale, NC 27545-7511 | 2009-06-23 |
| 1043476153 | E.w.stone Adult Care Service | Community/Behavioral Health | 1008f Big Oak Ct, Knightdale, NC 27545-8841 | 2008-07-29 |
| 1730444217 | Alexander Resilience, Inc. | Community/Behavioral Health | 742 Mcknight Dr, Suite 225, Knightdale, NC 27545-7764 | 2012-07-10 |
| Find all providers in KNIGHTDALE | ||||
| City | KNIGHTDALE |
| Zip Code | 27545 |
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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.