GRETCHEN ANN MCCORD NPI 1811001688

NPI Information

  • NPI: 1811001688
  • Provider Name: GRETCHEN ANN MCCORD
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 306 PADDOCK PLACE
    JACKSONVILLE, NC
    ZIP 28546
  • Phone: (910) 219-0635

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NPI Details

GRETCHEN ANN MCCORD is a community based residential treatment facility, intellectual and/or developmental disabilities in Jacksonville, 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. GRETCHEN ANN MCCORD NPI is 1811001688. The provider is registered as an organization entity type.

The provider's business location address is:

306 PADDOCK PLACE
JACKSONVILLE, NC
ZIP 28546
Phone: (910) 219-0635

The provider's authorized official is Gretchen Ann Mccord .
The authorized official title is Sole Proprietor and has the following contact phone number (910) 219-0635.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 10/2/2008.

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 DisabilitiesMHL-067-112NORTH 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
13409047MEDICAIDNORTH 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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