Amanda'S Place

LBN: Nicole St. Clair Services
Amanda'S Place is an health care organization with primary practice located at 4894 Highway 158 , Roanoke Rapids NC 27870. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Nicole St. Clair Services can be contacted via phone (252) 535-1192, or through Mallory, Karen via phone (252) 578-9071.

Contact Information

Primary practice address
4894 Highway 158 Roanoke Rapids NC 27870
Phone: (252) 535-1192
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mallory, Karen
Phone: (252) 578-9071

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X MHL042039 North Carolina

Profile Details

NPI number 1336272723
LBN Legal business name Nicole St. Clair Services
DBA Doing business as Amanda'S Place
Authorized official Mallory, Karen
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2007
Last updated Aug 22nd, 2020 - about 5 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 1336272723 NPPES
North Carolina MEDICAID H63008
North Carolina MEDICAID 6603561

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