Peaceful Dominion Group Home

LBN: Murray Adolescent Training &Tx Academy
Peaceful Dominion Group Home is an health care organization with primary practice located at 2012 Commonwealth Ave , Charlotte NC 28205-5022. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Murray Adolescent Training &Tx Academy can be contacted via phone (704) 372-4915, or through Murray, Cynthia S via phone (704) 372-4915.

Contact Information

Primary practice address
2012 Commonwealth Ave Charlotte NC 28205-5022
Phone: (704) 372-4915
Fax: (704) 372-4917
Website:
Map and Directions
Authorized official contact:
Name: Murray, Cynthia S
Phone: (704) 372-4915

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X 065181 North Carolina

Profile Details

NPI number 1225159676
LBN Legal business name Murray Adolescent Training &Tx Academy
DBA Doing business as Peaceful Dominion Group Home
Authorized official Murray, Cynthia S
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2007
Last updated Aug 22nd, 2020 - about 4 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 1225159676 NPPES
North Carolina MEDICAID 6603795

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