Organization Name: | CHAVIS MANOR, LLC |
NPI Number: | 1023399292 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEIRDRE LEA MILTON (OWNER) |
Mailing Address: | 204 Circle Dr Gibsonville |
State: | NC US |
Postal Code: | 272492310 |
Phone Number: | 3364375873 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2011 |
NPI Last Update Date: | 09/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3104A0625X |
License Number: | MHL041-1022 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | Assisted Living, Mental Illness |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |