COLLEGE LAKES – NPI #1841612215
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Health Care Provider Taxonomy Code for Residential Treatment Facility, Intellectual and/or Developmental Disabilities

COLLEGE LAKES is a residential treatment facility located in FAYETTEVILLE, NC. NPPES has assigned the NPI number 1841612215 to COLLEGE LAKES on January 20, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320600000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 5 years ago on Apr 21, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COLLEGE LAKES below.

NPI Profile for
COLLEGE LAKES

NPI Number
1841612215
Enumeration Date

(more than 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COLLEGE LAKES
Primary location
5104 FLATROCK DRIVE
FAYETTEVILLE, NC 28311
Phone: (910) 488-6323 Fax: (910) 223-2180
Mailing address
Same as primary location
Organization Subpart
Yes - COLLEGE LAKES is subpart of another organization.
Authorized Official
NIKKI CREECY
CEO
Phone: (910) 257-6406
Updated
Certification Date
Apr 21, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for COLLEGE LAKES

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNC3418071
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320600000X
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)		 NC MHL-047-133

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.