OrganizationActive
Central Care Division, LLC
NPI 1376692509 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Eden, NC
Provider details
- NPI number
- 1376692509
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Edward Staples, Owner(336) 635-2000
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense MHL-079-083 (NC)
Residential Treatment Facilities
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility320900000X
Residential Treatment Facilities
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility320900000XLicense MHL-079-080 (NC)
Residential Treatment Facilities
Practice location
722 Miles Street
Eden, NC 27288-2822
Phone: (336) 635-2000
Fax: (336) 635-2003
Approximate (ZIP-level) locationGet directions
Mailing address
405 N. Bridge St
Eden, NC 27288-5647
Registry dates
- Enumerated
- 2007-01-09
- Last updated
- 2010-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.