Konnoak Drive Group Home
LBN: Educare Community Living Corp North Carolina
Konnoak Drive Group Home is an health care organization with primary practice located at 2901 Konnoak Dr , Winston Salem NC 27127-3945. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty.
Educare Community Living Corp North Carolina can be contacted via phone (800) 866-0860, or through Mattingly, Angie via phone (502) 630-7425.
Contact Information
Primary practice address
2901 Konnoak Dr
Winston Salem NC 27127-3945
Phone: (800) 866-0860
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X | North Carolina | |
| Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded | 315P00000X |
Profile Details
| NPI number | 1639313943 |
|---|---|
| LBN Legal business name | Educare Community Living Corp North Carolina |
| DBA Doing business as | Konnoak Drive Group Home |
| Authorized official | Mattingly, Angie |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 30th, 2009 |
| Last updated | Feb 21st, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639313943 | NPPES |
| North Carolina | MEDICAID | 342606W |
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2901 Konnoak Dr , Winston Salem NC 27127-3945