Provider Demographics
NPI:1144083064
Name:ROOTED WITHIN LLC
Entity type:Organization
Organization Name:ROOTED WITHIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-873-3119
Mailing Address - Street 1:400 GILEAD RD PO BOX 19
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078
Mailing Address - Country:US
Mailing Address - Phone:202-873-3119
Mailing Address - Fax:
Practice Address - Street 1:711 SYLVAN ST SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5690
Practice Address - Country:US
Practice Address - Phone:202-873-3119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness