Our Fathers Place Inc
LBN: Our Fathers Place Inc
Our Fathers Place Inc is an health care organization with primary practice located at 256 East Broad Street , Statesville NC 28677. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness is the primary health care specialty.
Our Fathers Place Inc can be contacted via phone (704) 872-0313, or through Linton, James Russell via phone (704) 684-0197.
Contact Information
Primary practice address
256 East Broad Street
Statesville NC 28677
Phone: (704) 872-0313
Fax: (704) 872-7787
Website:
Authorized official contact:
Name: Linton, James Russell Master of Education (MED)
Phone: (704) 684-0197
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness | 320800000X | North Carolina | |
| Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children | 322D00000X | North Carolina |
Profile Details
| NPI number | 1275637423 |
|---|---|
| LBN Legal business name | Our Fathers Place Inc |
| DBA Doing business as | |
| Authorized official | Linton, James Russell Master of Education (MED) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 9th, 2006 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275637423 | NPPES |
| North Carolina | MEDICAID | 6603681 | |
| North Carolina | MEDICAID | 6603748 |
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