PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT) NPI 1003005240

Residential Treatment Facility, Emotionally Disturbed Children in Raleigh, NC

About PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT)

Phyd, Inc. (pretty Homes Youth Development) is a provider in Raleigh, NC. The NPI number assigned to this provider is 1003005240. The practitioner's primary taxonomy code is Residential Treatment Facility, Emotionally Disturbed Children (322D00000X). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Destiny Homes Of Phyd, Inc..

NPI1003005240 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NamePHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT)
Provider Location Address1611 POOLE RD RALEIGH, NC 27610 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing AddressPO BOX 20181 RALEIGH, NC 27619 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Other Organization NameDESTINY HOMES OF PHYD, INC. Additional informationCallout TooltipProvider other organization name
The alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. Codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Other Name TypeDoing Business As (3)
Enumeration Date10-23-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date03-26-2009 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT)
1611 POOLE RD
RALEIGH, NC
ZIP 27610
Phone: (919) 713-0035
Fax: (919) 713-0034
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Mailing Address

PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT)
PO BOX 20181
RALEIGH, NC
ZIP 27619
Phone: (919) 633-7800
Fax: (919) 713-0034

Primary Taxonomy

Taxonomy Code322D00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationResidential Treatment Facility, Emotionally Disturbed Children
TypeResidential Treatment Facilities
License No.MHL-092-537
License StateNC
Taxonomy DescriptionA provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.

Authorized Official

Authorized Official NameMRS. ANDREA PRETTY Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitlePRESIDENT
Authorized Official Phone(919) 633-7800

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed ChildrenMHL-092-491NCNo

Taxonomy Description: a provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
6603862MEDICAID (05)NC
6604280MEDICAID (05)NC

Map Location


PHYD, INC. (PRETTY HOMES YOUTH DEVELOPMENT) address is 1611 POOLE RD RALEIGH, NC 27610