Our Fathers Place Inc in Statesville - Community Based Residential Treatment Facility, Mental Illness
Our Fathers Place Inc - NPI 1275637423
Our Fathers Place Inc is a Community Based Residential Treatment Facility, Mental Illness in Statesville, North Carolina. Our Fathers Place Inc practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Our Fathers Place Inc is 1275637423. The last update date is 2020-08-22.
Our Fathers Place Inc's current location address is 256 East Broad Street, Statesville, North Carolina. You can contact this provider via phone number 7048720313 and fax number 7048727787. The mailing address for Our Fathers Place Inc is 256 East Broad Street, Statesville, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Our Fathers Place Inc |
|---|---|
| Address | 256 East Broad Street, Statesville, North Carolina |
| Phone Number | 7048720313 |
| Fax Number | 7048727787 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CHIEF EXEC |
|---|---|
| Authorized Official Name | Linton Russell James |
| Credentials | MED |
| Telephone Number | 7046840197 |
NPI Number Detail
| NPI Number | 1275637423 |
|---|---|
| Provider Enumeration Date | 2006-09-09 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 256 East Broad Street |
|---|---|
| City | Statesville |
| State | North Carolina (NC) |
| Post Code | 28677 |
| Phone Number | 7048720313 |
| Fax Number | 7048727787 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6603681 | NC | -- | |
| 6603748 | NC | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Our Fathers Place Inc by the Centers for Medicare & Medicaid Services?
The Our Fathers Place Inc has been issued the NPI (National Provider Identifier) 1275637423 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Our Fathers Place Inc located?
The Our Fathers Place Inc is located at 256 East Broad Street, Statesville, NC 28677.
What is Our Fathers Place Inc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Our Fathers Place Inc is Community Based Residential Treatment Facility, Mental Illness, and the taxonomy code that classifies this field of practice is 320800000X.
On what date did the Our Fathers Place Inc receive its 1275637423 assignment from the Centers for Medicare & Medicaid Services?
The Our Fathers Place Inc was assigned its 1275637423 by the Centers for Medicare & Medicaid Services on 2006-09-09.
As of what date was the information regarding Our Fathers Place Inc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Our Fathers Place Inc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-08-22.
NPI Number: 1336142389
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