OrganizationActive
Carolina Prime Residential LLC
NPI 1215545348 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Eden, NC
Provider details
- NPI number
- 1215545348
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Mikisha Simms, Director
Mailing address
315 Maple St
Eden, NC 27288-5513
Registry dates
- Enumerated
- 2020-07-15
- Last updated
- 2024-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.