JACKSONVILLE TREATMENT CENTER
NPI 1750763942
Clinic/Center - Rehabilitation, Substance Use Disorder in Jacksonville, NC
NPI Status: Active since June 24, 2015
Contact Information
806 BELL FORK RD
JACKSONVILLE, NC
ZIP 28540
Phone: (910) 347-2205
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
- CLIA Number: 34D2080194
- CLIA Cert. Type: Other - OUTPATIENT TREATMENT CNTR
- CLIA Exp. Date: 07-01-2026
About JACKSONVILLE TREATMENT CENTER
This page provides the complete NPI Profile along with additional information for Jacksonville Treatment Center, a provider established in Jacksonville, North Carolina operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1750763942 assigned on June 2015. The practitioner's primary taxonomy code is 261QR0405X with license number MHL067166 (NC). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Mr. Timothy Lamont Gunn (Program Director)
- NPI
- 1750763942
- Provider Name
- JACKSONVILLE TREATMENT CENTER
- Entity Type
- Organization
- Location Address
- 806 BELL FORK RD JACKSONVILLE, NC 28540
- Location Phone
- (910) 347-2205
- Mailing Address
- 806 BELL FORK RD JACKSONVILLE, NC 28540
- Mailing Phone
- (910) 347-2205
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-24-2015
- Last Update Date
- 06-24-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
- License No.
- MHL067166
- License State
- NC
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2080194
- Facility Type
- Other - OUTPATIENT TREATMENT CNTR
- Certificate Effective Date
- July 02, 2024
- Certificate Expiration Date
- July 01, 2026
- Laboratory Director
- TIMOTHY GUNN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Jacksonville Treatment Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 7 | 6 | 3 | 9 | 4 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 14 | 6 | 6 | 9 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 4 + 6 + 6 + 9 + 8 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1750763942 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 15 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1124539473 | CHARLOTTE GINYARD MAQP, LCAS-A Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1831604305 | MACY MELISSA HAMM LCAS Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1760983589 | SUSAN VEGA MS, LCAS-A Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1255833299 | MS. CATHERINE VERONICA JACOBS Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1982172045 | CHAKA MCKNIGHT MS, LCAS-A Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1528531464 | MS. MELISSA MONIQUE GRAHAM LCAS-A Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1699382408 | MS. ANTONIA EVETTE PERKINS Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1710512868 | BREANNA TIFFANY ELLIOTT LCAS-R Individual | Counselor (Addiction (Substance Use Disorder)) | 806 BELL FORK RD JACKSONVILLE, NC 28540 (910) 347-2205 |
| 1023875283 | PAUL JACOME SANCHEZ Individual | Behavior Technician | 806 BELL FORK RD JACKSONVILLE, NC 28540 (252) 341-4192 |
| 1588422695 | ALANI COLON Individual | Behavior Technician | 806 BELL FORK RD JACKSONVILLE, NC 28540 (252) 341-4192 |
| 1649022443 | TERRI HAYES Individual | Behavior Technician | 806 BELL FORK RD JACKSONVILLE, NC 28540 (252) 341-4192 |
| 1912759713 | ELIZABETH KOLLER Individual | Behavior Technician | 806 BELL FORK RD JACKSONVILLE, NC 28540 (252) 341-4192 |
| 1962269225 | RACHEL ANNE CREWS Individual | Behavior Technician | 806 BELL FORK RD JACKSONVILLE, NC 28540 (242) 341-4192 |
| 1366203895 | KAYLA LYNNE TRICKEL Individual | Behavior Technician | 806 BELL FORK RD JACKSONVILLE, NC 28540 (252) 341-4192 |
| 1275322778 | HARLEY TAYLOR Individual | Behavior Technician | 806 BELL FORK RD JACKSONVILLE, NC 28540 (866) 727-8274 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750763942, enumerated in the NPI registry as an "organization" on June 24, 2015
The provider is located at 806 Bell Fork Rd Jacksonville, Nc 28540 and the phone number is (910) 347-2205
This medical organization specializes in Clinic/Center with taxonomy code 261QR0405X with a focus in Rehabilitation, Substance Use Disorder
The provider's CLIA number is 34D2080194 for a "other - outpatient treatment cntr" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on June 24, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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