ELY ENTERPRISES, INC. (NPI# 1881891521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881891521 |
| Entity Type | Organization |
| Organization Name | ELY ENTERPRISES, INC. |
| Practice Address |
3999 Fayetteville Road Raeford NC 28376-0274 |
| Mailing Address |
Po Box 274 Raeford NC 28376-0274 |
| Practice Telephone | 9106836476 |
| Practice Fax Number | 9106836476 |
| Mailing Telephone | 9106836476 |
| Mailing Fax Number | 9106836476 |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2009-05-08 |
| Authorized Official Name | MR. CALVIN DONNELL ELY (CO-ADMINISTRATOR) |
| Authorized Official Telephone | 9106836476 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-047-049 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 3418202 | 05 | |
| NC | 7804458 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporation | Ely Enterprises, Inc. | 3999 Fayetteville Road , Raeford, NC 28376 |
| Virginia Business Entity | Ely Enterprises, Inc. | 2072 EAST BRANCH LOOP , ROSELAND, VA 22967 |
| Street Address |
3999 FAYETTEVILLE ROAD |
| City | RAEFORD |
| State | NC |
| Zip Code | 28376-0274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578185104 | Elite Supply Services, Inc. | Durable Medical Equipment & Medical Supplies | 2148 Bus-us 401, Raeford, NC 28376 | 2020-05-18 |
| 1205485695 | Brenda P Gregorio | Technician | 297 Gregorios Ln, Raeford, NC 28376 | 2019-09-09 |
| 1083197115 | Jennifer Picerno Bowyer | Nurse Practitioner | 929 Prospect Ave., Raeford, NC 28376 | 2018-09-14 |
| 1730694746 | Embassy Health Network | Counselor | 2148 Hwy 401 Business, Raeford, NC 28376 | 2017-12-13 |
| 1508398991 | Rockfish Pharmacy Inc | Pharmacy | 221 Flagstone Lane, Raeford, NC 28376 | 2017-04-03 |
| 1205281235 | William Fiebig | Nurse Practitioner | Hoke Hospital, 210 Medical Pavilion Drive, Raeford, NC 28376 | 2016-04-27 |
| 1306200647 | Tia Hart Community Recovery Program | Community/Behavioral Health | 2188 A Us 401 Business, Raeford, NC 28376 | 2016-04-13 |
| 1508240631 | Integrated Mental Health Services Agency Inc | Community/Behavioral Health | 2188-a Hwy 401 Business, Raeford, NC 28376 | 2015-07-18 |
| 1649658287 | Divine Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 320 Birch St, Raeford, NC 28376 | 2015-05-15 |
| 1992192298 | David Abdulhaqq | Counselor | 225 Aggies Lane, Raeford, NC 28376 | 2015-04-24 |
| Find all providers in zip 28376 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487028254 | Sisterly Love | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 170 Club Pond Rd, Raeford, NC 28376-9291 | 2015-11-17 |
| 1114225554 | Lend A Helping Hand, Inc #2 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 304 Riley St, Raeford, NC 28376-5765 | 2011-03-09 |
| 1568792109 | Serenity Therapeutic Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 207 South Stewart Street, Raeford, NC 28376-3112 | 2010-01-04 |
| 1114154895 | Monarch | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 S Wright St, Raeford, NC 28376-3122 | 2009-06-19 |
| 1881837854 | Open Arms | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 172 Drew St, Raeford, NC 28376-6639 | 2009-04-07 |
| 1538357439 | Great Expectations Mental Health Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1416 Darby Dr, Raeford, NC 28376-8462 | 2007-10-05 |
| 1497942221 | Great Expectations Mental Health Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 574 Carriage Ln, Raeford, NC 28376-6384 | 2007-09-25 |
| 1831391770 | Lend A Helping Hand, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 114 Van Buren Dr, Raeford, NC 28376-9412 | 2007-06-04 |
| 1700910403 | Higher Horizons Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 229 Azalea Street, Raeford, NC 28376-9019 | 2007-03-15 |
| 1073650446 | Forever Young Secured Community | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 181 Bostic Rd, Raeford, NC 28376-6101 | 2007-02-01 |
| Find all providers in RAEFORD | ||||
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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.