CENTRAL CARE DIVISION LLC NPI 1376692509

NPI Information

  • NPI: 1376692509
  • Provider Name: CENTRAL CARE DIVISION, LLC
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 722 MILES STREET
    EDEN, NC
    ZIP 27288
  • Phone: (336) 635-2000

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NPI Details

CENTRAL CARE DIVISION, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Eden, NC. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. CENTRAL CARE DIVISION, LLC NPI is 1376692509. The provider is registered as an organization entity type.

The provider's business location address is:

722 MILES STREET
EDEN, NC
ZIP 27288-822
Phone: (336) 635-2000
Fax: (336) 635-2003

The provider's authorized official is Edward F. Staples .
The authorized official title is Owner and has the following contact phone number (336) 635-2000.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 9/13/2010.

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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesNo
2320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-079-080NORTH CAROLINANo
3320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-079-083NORTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16603595MEDICAIDNORTH CAROLINA
28301618BMEDICAIDNORTH CAROLINA
38301618MEDICAIDNORTH CAROLINA
46603985MEDICAIDNORTH CAROLINA
53418285MEDICAIDNORTH 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: 11/21/2025

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