EDUCARE COMMUNITY LIVING CORP NC NPI 1215057856

NPI Information

NPI: 1215057856
Provider Name: EDUCARE COMMUNITY LIVING CORP NC

Other Name: EDUCARE RAL BLANCHE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

Address:
6208 BLANCHE DR
RALEIGH, NC
ZIP 27607
Phone: (919) 859-1450
Get Directions

EDUCARE COMMUNITY LIVING CORP NC is an intermediate care facility mentally retarded in Raleigh, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. EDUCARE COMMUNITY LIVING CORP NC NPI is 1215057856. The provider is registered as an organization entity type.
The provider Other Name Is Educare Ral Blanche.

The provider's business location address is:

6208 BLANCHE DR
RALEIGH, NC
ZIP 27607-008
Phone: (919) 859-1450

The provider's authorized official is Timothy Whobrey .
The authorized official title is Provider Enrollment and has the following contact phone number (502) 630-7249.

The CLIA number assigned to this NPI record is 34D2271271 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2007 and was last updated on 10/19/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3406421	MEDICAID	NORTH 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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