Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Carolina Prime Residential LLC

Organization Mental Illness Community Based Residential Treatment Facility · NPI 1215545348

Carolina Prime Residential LLC is a Mental Illness Community Based Residential Treatment Facility in Eden, North Carolina. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

315 Maple St
Eden, NC 27288-5513
Phone: (336) 623-1020
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X
Mental Illness Community Based Residential Treatment Facility Taxonomy 320800000X

Record details

NPI number1215545348
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mikisha Simms — Director · (301) 717-2040
NPI enumeratedJuly 15, 2020
Last updated in NPPESApril 10, 2024
Certification dateApril 10, 2024
Mailing address315 Maple St, Eden, NC 27288-5513

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