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TINDERWOOD NPI 1477788446


NPI Information

NPI: 1477788446
Provider Name: TINDERWOOD
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
102 TINDERWOOD DR
GOLDSBORO, NC
ZIP 27534
Phone: (919) 734-0266
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TINDERWOOD is a residential treatment facility, intellectual and/or developmental disabilities in Goldsboro, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. TINDERWOOD NPI is 1477788446. The provider is registered as an organization entity type.

The provider's business location address is:

102 TINDERWOOD DR
GOLDSBORO, NC
ZIP 27534
Phone: (919) 734-0266
Fax: (919) 734-9926

The provider's authorized official is Diane Harrison .
The authorized official title is President and has the following contact phone number (919) 734-0266.

The enumeration date for this NPI number is 5/20/2009 and was last updated on 5/20/2009.


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
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-096-088NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17803464MEDICAIDNORTH CAROLINA

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: 4/28/2024

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