Self-Determination Llc

LBN: Self-Determination Llc
Self-Determination Llc is an health care organization with primary practice located at 103 Ebenezer Rd , Kings Mtn NC 28086. The organization recently has 5 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children. Agencies / Case Management is the primary health care specialty. Self-Determination Llc can be contacted via phone (704) 750-4752, or through Jefferies, Floydce via phone (828) 433-0465.

Contact Information

Primary practice address
103 Ebenezer Rd Kings Mtn NC 28086
Phone: (704) 750-4752
Fax: (704) 750-4753
Website:
Map and Directions
Authorized official contact:
Name: Jefferies, Floydce
Phone: (828) 433-0465

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X 023-197 North Carolina
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X 012-129 North Carolina

Profile Details

NPI number 1639408248
LBN Legal business name Self-Determination Llc
DBA Doing business as
Authorized official Jefferies, Floydce
Entity Organization
Organization subpart 1 No
Enumeration date Dec 9th, 2009
Last updated Aug 10th, 2018 - about 6 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 1639408248 NPPES
North Carolina MEDICAID 6604454

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