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COMMUNITY INNOVATIONS INC 63
NPI 1407931611
Intermediate Care Facility, Intellectual Disabilities in Holly Springs, NC

Active since October 26, 2006
904 AVENT FERRY RD, HOLLY SPRINGS, NC 27540(919) 577-6749 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Community Innovations Inc 63 NPPES

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

COMMUNITY INNOVATIONS INC 63 (NPI 1407931611) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Holly Springs, North Carolina and active in the NPI registry since October 2006. The organization lists Andy Anderson, President, as its authorized official.

NPPES Registry Identity

NPI1407931611
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameCOMMUNITY INNOVATIONS INC 63
Location Address904 AVENT FERRY RDHolly Springs, NC 27540-8416
Mailing Address3210 Fairhill DrRaleigh, NC 27612-3220 · (919) 256-0824
Phone(919) 577-6749
Organization SubpartNo
Authorized OfficialAndy AndersonPresident · (910) 642-5697
Enumeration DateOctober 26, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1407931611 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 · MHL092126
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
904 AVENT FERRY RD, Holly Springs, NC 27540
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Other Identifiers 1

Medicaid340605JNC

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RHA HEALTH SERVICES NC LLC
Intermediate Care Facility, Intellectual Disabilities
904 AVENT FERRY RD
HOLLY SPRINGS, NC 27540
Wake County (800) 848-0180

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 Community Innovations Inc 63's NPI number?

The NPI number for Community Innovations Inc 63 is 1407931611. It was assigned to this organization in the NPPES registry on October 26, 2006.

Where is Community Innovations Inc 63 located?

Community Innovations Inc 63 is located at 904 Avent Ferry Rd, Holly Springs, NC 27540. The listed phone number is (919) 577-6749.

What is Community Innovations Inc 63's specialty?

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

When was this NPI record last updated?

The NPPES record for Community Innovations Inc 63 was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.