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PIEDMONT RESIDENTIAL DEVELOPMENT CENTER, INC
NPI 1174669261
Intermediate Care Facility, Intellectual Disabilities in Concord, NC

Active since January 29, 2007CLIA 34D2104339 · Waiver
630 WILHELM PL NE, CONCORD, NC 28025(704) 788-2304(704) 788-2951 Get Directions Write a Review

NPPES record last updated: August 27, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Piedmont Residential Development Center, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PIEDMONT RESIDENTIAL DEVELOPMENT CENTER, INC (NPI 1174669261) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Concord, North Carolina and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through November 1, 2027 and lists Sharon A Lipke, Finance Director, as its authorized official.

NPPES Registry Identity

NPI1174669261
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NamePIEDMONT RESIDENTIAL DEVELOPMENT CENTER, INC
Location Address630 WILHELM PL NEConcord, NC 28025-2532
Mailing AddressPo Box 909Concord, NC 28026-0909 · (704) 788-2304 · Fax (704) 788-2951
Phone(704) 788-2304
Fax(704) 788-2951
Organization SubpartNo
Authorized OfficialSharon A LipkeFinance Director · (704) 788-2304
Enumeration DateJanuary 29, 2007
Last NPPES UpdateAugust 27, 2012
✔ NPI 1174669261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in NC · MHL-013-019
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
630 WILHELM PL NE, Concord, NC 28025
Open in Google Maps ↗

Other Identifiers 1

Medicaid3406118NC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2104339

Piedmont Residential Development Center · Concord, NC
Active · expires Nov 1, 2027
CLIA Number34D2104339
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateNovember 2, 2025
Certificate Expiration DateNovember 1, 2027
Laboratory DirectorDavid Pavelock
Laboratory Phone(704) 788-2304
Laboratory LocationPiedmont Residential Development Center5300 Highway 200, Concord, NC 28025
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Piedmont Residential Development Center, Inc's NPI number?

The NPI number for Piedmont Residential Development Center, Inc is 1174669261. It was assigned to this organization in the NPPES registry on January 29, 2007.

Where is Piedmont Residential Development Center, Inc located?

Piedmont Residential Development Center, Inc is located at 630 Wilhelm Pl NE, Concord, NC 28025. The listed phone number is (704) 788-2304.

What is Piedmont Residential Development Center, Inc's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Piedmont Residential Development Center, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2104339) is associated with this NPI, valid through November 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Piedmont Residential Development Center, Inc was last updated on August 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.