Provider Demographics
NPI:1164978177
Name:NEW YORK HOMES RESIDENTIAL CARE CENTER
Entity Type:Organization
Organization Name:NEW YORK HOMES RESIDENTIAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-319-8123
Mailing Address - Street 1:82 INGLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-9610
Mailing Address - Country:US
Mailing Address - Phone:828-665-0960
Mailing Address - Fax:
Practice Address - Street 1:11 WAPITI CT
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-0709
Practice Address - Country:US
Practice Address - Phone:828-319-8123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED SUPPORT SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC011373323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409493Medicaid