Mountain Ridge Group Home

LBN: Lutheran Family Services In The Carolinas
Mountain Ridge Group Home is an health care organization with primary practice located at 810 King Arthur Dr , Gastonia NC 28056-8469. The organization recently has 3 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty. Lutheran Family Services In The Carolinas can be contacted via phone (704) 824-8941, or through Nickerson, Kirby via phone (704) 754-8228.

Contact Information

Primary practice address
810 King Arthur Dr Gastonia NC 28056-8469
Phone: (704) 824-8941
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Nickerson, Kirby
Phone: (704) 754-8228

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X MHL036031 North Carolina
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X MHL-036-031 North Carolina

Profile Details

NPI number 1851447221
LBN Legal business name Lutheran Family Services In The Carolinas
DBA Doing business as Mountain Ridge Group Home
Authorized official Nickerson, Kirby
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 26th, 2007
Last updated Jun 26th, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851447221 NPPES
North Carolina MEDICAID 3416485

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