Organization · NPI-2
Piedmont Residential Development Center, INC
Intermediate Care Facility, Intellectual Disabilities · Concord, NC
NPI number1649334996
StatusActive
Last updated in NPPESSep 20, 2012
Details
- NPI
- 1649334996
- Entity type
- Organization (NPI-2)
- Legal business name
- Piedmont Residential Development Center, INC
- Organization subpart
- No
- Enumeration date
- Dec 21, 2006
- Last updated
- Sep 20, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | MHL-013-019 | NC | Yes |
Practice location
5300 Hwy 200Concord, NC 28025
Phone 704-788-2304 · Fax 704-788-2951
Mailing address
Po Box 909Concord, NC 28026-0909
Phone 704-788-2304 · Fax 704-788-2951
Authorized official
Sharon A Lipke
Finance Director
7047882304
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