Organization · NPI-2

Piedmont Residential Development Center, INC

Intermediate Care Facility, Intellectual Disabilities · Concord, NC

NPI number1174669261
StatusActive
Last updated in NPPESAug 27, 2012

Details

NPI
1174669261
Entity type
Organization (NPI-2)
Legal business name
Piedmont Residential Development Center, INC
Organization subpart
No
Enumeration date
Jan 29, 2007
Last updated
Aug 27, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
315P00000X Intermediate Care Facility, Intellectual DisabilitiesMHL-013-019NCYes

Practice location

630 Wilhelm Pl Ne
Concord, NC 28025-2532

Phone 704-788-2304 · Fax 704-788-2951

Mailing address

Po Box 909
Concord, NC 28026-0909

Phone 704-788-2304 · Fax 704-788-2951

Authorized official

Sharon A Lipke
Finance Director
7047882304

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