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MURRAY ADOLESCENT TRAINING & TXMENT ACADEMY NPI 1528188802


NPI Information

NPI: 1528188802
Provider Name: MURRAY ADOLESCENT TRAINING & TXMENT ACADEMY

Other Name: PROMISE KEEPERS GROUP HOME

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
2012 COMMONWEALTH AVE
CHARLOTTE, NC
ZIP 28205
Phone: (704) 372-4915
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MURRAY ADOLESCENT TRAINING & TXMENT ACADEMY is a residential treatment facility emotionally disturbed children in Charlotte, NC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. MURRAY ADOLESCENT TRAINING & TXMENT ACADEMY NPI is 1528188802. The provider is registered as an organization entity type.
The provider Other Name Is Promise Keepers Group Home.

The provider's business location address is:

2012 COMMONWEALTH AVE
CHARLOTTE, NC
ZIP 28205-022
Phone: (704) 372-4915
Fax: (704) 372-4917

The provider's authorized official is Cynthia S Murray .
The authorized official title is Vice President and has the following contact phone number (704) 372-4915.

The enumeration date for this NPI number is 3/30/2007 and was last updated on 8/22/2020.


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
1322D00000XResidential Treatment Facility, Emotionally Disturbed Children060-394NORTH 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
16603431MEDICAIDNORTH 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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