MAKING A DIFFERENCE COMMUNITY SUPPORT LLC (NPI# 1912186735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912186735 |
| Entity Type | Organization |
| Organization Name | MAKING A DIFFERENCE COMMUNITY SUPPORT LLC |
| Practice Address |
102 Old Tom Ave. Manteo NC 27954 |
| Mailing Address |
Po Box 7672 Kill Devil Hills NC 27948-6672 |
| Practice Telephone | 2524759829 |
| Mailing Telephone | 2524759829 |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-11-01 |
| Authorized Official Name | SHANEQUA CORNISE BENTON (MEMBER/ORGANIZER) |
| Authorized Official Telephone | 2524759829 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
261QM0855X | NC | Ambulatory Health Care Facilities |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
261QM0850X | NC | Ambulatory Health Care Facilities |
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
261QR0400X | NC | Ambulatory Health Care Facilities |
| Street Address |
102 OLD TOM AVE. |
| City | MANTEO |
| State | NC |
| Zip Code | 27954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316598873 | Island Pharmacy Inc | Pharmacy | 210 S Us Hwy 64/264, Manteo, NC 27954 | 2019-09-26 |
| 1104300847 | Saskia Thompson | Pharmacist | Cvs, 1115 South, Us-64, Manteo, NC 27954 | 2018-09-19 |
| 1619372273 | Gina Booth | Massage Therapist | 711 N Hwy 64, Manteo, NC 27954 | 2014-10-24 |
| 1184052870 | Katherine Ruth Moore | Pharmacist | 1115 South Us Highway 64, Manteo, NC 27954 | 2013-10-16 |
| 1033556162 | Troy B Sluder IIi Dds Pllc | Dentist | 503 Cypress Lane Suite C, Manteo, NC 27954 | 2013-05-30 |
| 1013219369 | Amanda Elizabeth Hall | Speech-Language Pathologist | 706 Arvilla Lane, Manteo, NC 27954 | 2010-11-18 |
| 1619156718 | Dare Medical & Cardiovascular Associates | Internal Medicine | 604 Amanda Street, Manteo, NC 27954 | 2007-10-25 |
| 1518164607 | Heather R Wedgworth | Physical Therapist | 110 S Us Hwy 64/264, Manteo, NC 27954 | 2007-07-02 |
| 1306048186 | Dare County Department of Social Services | Public Health or Welfare | 107 Exeter St., Manteo, NC 27954 | 2007-06-04 |
| 1508908617 | Kelly F Roberts | Social Worker | 704 North Hwy 64, Manteo, NC 27954 | 2007-02-13 |
| Find all providers in zip 27954 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726567 | Carolina Physical Therapy Associates LLC | Clinic/Center | 236 Lephillips Court, Suite A, Concord, NC 28025-1917 | 2020-09-29 |
| 1063027597 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 3611 Mt Holly Hntrsvl Rd Bldg 200, Charlotte, NC 28216-8636 | 2020-09-11 |
| 1508478918 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 150 Wellesley Trade Ln, Cary, NC 27519 | 2020-08-18 |
| 1154963346 | Carolina Physical Therapy Associates LLC | Clinic/Center | 1129 Weaver Dairy Rd Ste N, Chapel Hill, NC 27514-1960 | 2019-10-09 |
| 1861042574 | Trainer's B's Fitness World, Inc. | Clinic/Center | 1225 S Church St Ste B, Charlotte, NC 28203-4197 | 2019-09-14 |
| 1699333021 | Stephanie Carlile Elam | Clinic/Center | Carolina Care Health and Rehab, 111 Harrilson Road, Cherryville, NC 28021 | 2019-05-31 |
| 1023579828 | Carolina Physical Therapy Associates LLC | Clinic/Center | 5476 Apex Peakway, Apex, NC 27502-3924 | 2019-03-26 |
| 1386121606 | Carolina Physical Therapy Associates LLC | Clinic/Center | 13200 Strickland Rd Ste 134, Raleigh, NC 27613-5214 | 2018-07-20 |
| 1467964189 | Cora North Carolina, LLC | Clinic/Center | 1115 Military Cutoff Rd Ste A, Wilmington, NC 28405-3660 | 2017-11-03 |
| 1568971919 | Select Physical Therapy Holdings, Inc. | Clinic/Center | 2654 Dr Martin Luther King Jr Blvd, New Bern, NC 28562-4238 | 2017-09-28 |
| Find all providers with the same taxonomy | ||||
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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.