SELF-DETERMINATION LLC NPI 1639408248

NPI Information

NPI: 1639408248
Provider Name: SELF-DETERMINATION LLC
Classification: Case Management - 251B00000X
Entity Type: Organization
Address: 103 EBENEZER RD
KINGS MTN, NC
ZIP 28086
Phone: (704) 750-4752

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NPI Details

SELF-DETERMINATION LLC is a case management in Kings Mtn, NC. The provider is an organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. SELF-DETERMINATION LLC NPI is 1639408248. The provider is registered as an organization entity type.

The provider's business location address is:

103 EBENEZER RD
KINGS MTN, NC
ZIP 28086
Phone: (704) 750-4752
Fax: (704) 750-4753

The provider's authorized official is Floydce Jefferies .
The authorized official title is President and has the following contact phone number (828) 433-0465.

The enumeration date for this NPI number is 12/9/2009 and was last updated on 8/10/2018.

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	261QD1600X	Clinic/Center	Developmental Disabilities			No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness		023-197	NORTH CAROLINA	No
3	251S00000X	Community/Behavioral Health				No
4	320800000X	Community Based Residential Treatment Facility, Mental Illness				No
5	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		012-129	NORTH CAROLINA	No
6	251B00000X	Case Management				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	6604454	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: 11/21/2025

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