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BANYAN MOORESVILLE LLC
NPI 1427898147
Substance Abuse Rehabilitation Facility in Mooresville, NC

Active since May 30, 2024CLIA 34D2344761 · Waiver
291 COMMERCIAL DR, MOORESVILLE, NC 28115(954) 533-7705(954) 781-7173 Get Directions Write a Review

NPPES record last updated: May 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Banyan Mooresville Llc NPPES

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

BANYAN MOORESVILLE LLC (NPI 1427898147) is a healthcare organization registered as a substance abuse rehabilitation facility in Mooresville, North Carolina and active in the NPI registry since May 2024. The organization holds a CLIA Waiver certificate valid through May 28, 2028 and lists John Sory, Ceo, as its authorized official.

NPPES Registry Identity

NPI1427898147
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameBANYAN MOORESVILLE LLC
Location Address291 COMMERCIAL DRMooresville, NC 28115-7870
Mailing Address225 N Federal HwyPompano Beach, FL 33062-4319 · (954) 533-7705 · Fax (954) 781-7173
Phone(954) 533-7705
Fax(954) 781-7173
Organization SubpartNo
Authorized OfficialJohn SoryCeo · (954) 533-7705
Enumeration DateMay 30, 2024
NPPES CertifiedMay 30, 2024
✔ NPI 1427898147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X
Also ListedPsychiatric HospitalTaxonomy 283Q00000X
Also ListedPsychiatric Residential Treatment FacilityTaxonomy 323P00000X
291 COMMERCIAL DR, Mooresville, NC 28115
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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 34D2344761

Banyan Mooresville LLC · Mooresville, NC
Active · expires May 28, 2028
CLIA Number34D2344761
Laboratory TypeSud Treatment Center
Certificate Effective DateMay 29, 2026
Certificate Expiration DateMay 28, 2028
Laboratory DirectorDarrin Mangiacarne
Laboratory Phone(980) 781-3950
Laboratory LocationBanyan Mooresville LLC291 Commerical Drive, Mooresville, NC 28115
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

TTB ENTERPRISES, LLC
Assisted Living Facility
291 COMMERCIAL DR
MOORESVILLE, NC 28115
Iredell County (704) 663-7600

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 Banyan Mooresville LLC's NPI number?

The NPI number for Banyan Mooresville LLC is 1427898147. It was assigned to this organization in the NPPES registry on May 30, 2024.

Where is Banyan Mooresville LLC located?

Banyan Mooresville LLC is located at 291 Commercial Dr, Mooresville, NC 28115. The listed phone number is (954) 533-7705.

What is Banyan Mooresville LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Banyan Mooresville LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2344761) is associated with this NPI, valid through May 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Banyan Mooresville LLC was last updated on May 30, 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.