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NPI 1326476383 · Intellectual Disabilities Intermediate Care Facility · Aberdeen, NC
Provider details
- NPI number
- 1326476383
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Rodney Johnson, Ceo(910) 321-0069
- License
- MHL-063-105 (NC)
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Intellectual and/or Developmental Disabilities Residential Treatment Facility320600000XLicense MHL-063-105 (NC)
Residential Treatment Facilities
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1112 Devonshire Trl
Aberdeen, NC 28315-3910
Phone: (910) 944-1674
Street-level locationGet directions
Mailing address
401 Robeson Street
Fayetteville, NC 28301
Registry dates
- Enumerated
- 2013-10-29
- Last updated
- 2020-07-15
- Certified
- 2020-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.