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DEREK'S PLACE NPI 1033651070


NPI Information

NPI: 1033651070
Provider Name: DEREK'S PLACE
Classification: Home Health - 251E00000X
Entity Type: Organization
Address:
150 SECRET GARDEN LN
APT 1
WINSTON SALEM, NC
ZIP 27104
Phone: (336) 671-3046
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DEREK'S PLACE is a home health in Winston Salem, NC. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. DEREK'S PLACE NPI is 1033651070. The provider is registered as an organization entity type.

The provider's business location address is:

150 SECRET GARDEN LN
APT 1
WINSTON SALEM, NC
ZIP 27104-721
Phone: (336) 671-3046

The provider's authorized official is Eric Hairston .
The authorized official title is Executive Administrator and has the following contact phone number (336) 671-3046.

The enumeration date for this NPI number is 11/8/2016 and was last updated on 11/8/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251C00000XDay Training, Developmentally Disabled ServicesNo
2385HR2060XRespite CareRespite Care, Intellectual and/or Developmental DisabilitiesNo
3251E00000XHome HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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