Provider Demographics
NPI:1497446041
Name:CAROLINA HEALTHCARE NETWORK, LLC
Entity Type:Organization
Organization Name:CAROLINA HEALTHCARE NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUMPPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-512-9166
Mailing Address - Street 1:359 MCGOUGAN RD
Mailing Address - Street 2:
Mailing Address - City:LUMBER BRIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28357-9641
Mailing Address - Country:US
Mailing Address - Phone:850-512-9166
Mailing Address - Fax:877-472-2302
Practice Address - Street 1:1892 TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-8520
Practice Address - Country:US
Practice Address - Phone:850-512-9166
Practice Address - Fax:877-472-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children