LUTHERAN FAMILY SERVICES IN THE CAROLINAS NPI 1225184872

Residential Treatment Facility, Physical Disabilities in Winston Salem, NC

Organization Residential Treatment Facility, Physical...

About LUTHERAN FAMILY SERVICES IN THE CAROLINAS

Lutheran Family Services In The Carolinas is a provider established in Winston Salem, North Carolina specializing in residential treatment facility, physical disabilities. The NPI number of Lutheran Family Services In The Carolinas is 1225184872 and was assigned on January 2007. The practitioner's primary taxonomy code is 320700000X with license number MHL-034-139 (NC). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mr. Dwight Murray (Ar And Contracts Manager)

NPI

1225184872

Provider NameLUTHERAN FAMILY SERVICES IN THE CAROLINAS
Provider Location Address1007 N PEACE HAVEN RD WINSTON SALEM, NC 27104
Provider Mailing AddressPO BOX 12287 RALEIGH, NC 27605
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?N/A
Enumeration Date01-26-2007
Last Update Date07-09-2007

Primary Taxonomy

Taxonomy Code320700000X
ClassificationResidential Treatment Facility, Physical Disabilities
TypeResidential Treatment Facilities
License No.MHL-034-139
License StateNC
Taxonomy DescriptionA residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.

Business Address

LUTHERAN FAMILY SERVICES IN THE CAROLINAS
1007 N PEACE HAVEN RD
WINSTON SALEM, NC
ZIP 27104
Phone: (336) 659-1247

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Mailing Address

LUTHERAN FAMILY SERVICES IN THE CAROLINAS
PO BOX 12287
RALEIGH, NC
ZIP 27605
Phone: (919) 832-2620

Authorized Official

Authorized Official NameMR. DWIGHT MURRAY
Authorized Official TitleAR AND CONTRACTS MANAGER
Authorized Official Phone(919) 861-2850

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
8301053BMEDICAID (05)NC
8301053MEDICAID (05)NC

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider 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 Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type 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)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart 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.

Provider Other Organization Name
The other organization name is 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. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary 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.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.