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E & T ALLIANCE LLC NPI 1861563488


NPI Information

NPI: 1861563488
Provider Name: E & T ALLIANCE LLC

Doing Business As: A HEALTHY HAVEN

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
410 MARCIA DR
GOLDSBORO, NC
ZIP 27530
Phone: (919) 734-9956
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E & T ALLIANCE LLC is a residential treatment facility emotionally disturbed children in Goldsboro, 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. E & T ALLIANCE LLC NPI is 1861563488. The provider is registered as an organization entity type.
The provider Is Doing Business As A Healthy Haven.

The provider's business location address is:

410 MARCIA DR
GOLDSBORO, NC
ZIP 27530-213
Phone: (919) 734-9956

The provider's authorized official is Mark Ellermeier .
The authorized official title is President and has the following contact phone number (919) 734-9956.

The enumeration date for this NPI number is 11/13/2006 and was last updated on 3/6/2009.


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 ChildrenMHL-096178NORTH 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
16603996MEDICAIDNORTH 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: 11/14/2023

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