CAROLINA PRIME RESIDENTIAL LLC
NPI 1215545348
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Eden, NC

Q: What is Carolina Prime Residential LLC's NPI number?

The NPI number for Carolina Prime Residential LLC is 1215545348. It was assigned to this organization in the NPPES registry on July 15, 2020.

Q: What is Carolina Prime Residential LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Active since July 15, 2020

315 MAPLE ST, EDEN, NC 27288(336) 623-1020 Get Directions Write a Review

NPPES record last updated: April 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 10, 2024, Dec 19, 2020, Jul 15, 2020 (3 updates tracked since 2020).

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About Carolina Prime Residential Llc NPPES

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

CAROLINA PRIME RESIDENTIAL LLC (NPI 1215545348) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Eden, North Carolina and active in the NPI registry since July 2020. The organization lists Mikisha Simms, Director, as its authorized official.

NPPES Registry Identity

NPI1215545348

Entity TypeOrganization

Primary Taxonomy320900000X

Legal Business NameCAROLINA PRIME RESIDENTIAL LLC

Location Address315 MAPLE STEden, NC 27288-5513

Mailing Address315 Maple StEden, NC 27288-5513 · (336) 763-5620

Phone(336) 623-1020

Organization SubpartNo

Authorized OfficialMikisha SimmsDirector · (301) 717-2040

Enumeration DateJuly 15, 2020

Last NPPES UpdateApril 10, 20243 updates tracked since enumeration

NPPES CertifiedApril 10, 2024

✔ NPI 1215545348 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Also ListedCommunity Based Residential Treatment Facility, Mental IllnessTaxonomy 320800000X

315 MAPLE ST, Eden, NC 27288

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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 Carolina Prime Residential LLC's NPI number?

The NPI number for Carolina Prime Residential LLC is 1215545348. It was assigned to this organization in the NPPES registry on July 15, 2020.

Where is Carolina Prime Residential LLC located?

Carolina Prime Residential LLC is located at 315 Maple St, Eden, NC 27288. The listed phone number is (336) 623-1020.

What is Carolina Prime Residential LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Carolina Prime Residential LLC was last updated on April 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.