Self-Determination LLC

Self-Determination LLC is a healthcare organization registered as Case Management Agency in Kings Mtn, NC, holding Type 2 (organization) NPI 1639408248 since 2009. The authorized official on file is Floydce Jefferies, President.

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NPI	1639408248
Entity type	Organization (Type 2)
Legal business name	Self-Determination LLC
Practice address	103 EBENEZER RD, Kings Mtn, NC, 28086
Phone	7047504752
Fax	7047504753
Enumeration date	2009-12-09
Last updated in NPPES	2018-08-10

Authorized official

Name	Floydce Jefferies
Title	President
Phone	8284330465

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261QD1600X	Developmental Disabilities Clinic/Center	Secondary	—	—
320800000X	Mental Illness Community Based Residential Treatment Facility	Secondary	023-197	NC
251S00000X	Community/Behavioral Health Agency	Secondary	—	—
320800000X	Mental Illness Community Based Residential Treatment Facility	Secondary	—	—
322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	Secondary	012-129	NC
251B00000X	Case Management Agency	Primary	—	—

Other identifiers

Identifier	Type	State	Issuer
6604454	Medicaid	NC	—

Copy-ready billing details

Provider: Self-Determination LLC
NPI: 1639408248
Taxonomy: 251B00000X (Case Management Agency)
Address: 103 EBENEZER RD, Kings Mtn, NC, 28086

Verify this record

Cross-check NPI 1639408248 against the authoritative CMS record: view Self-Determination LLC on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Self-Determination LLC located?

The practice location on file with NPPES is in Kings Mtn, NC.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2018-08-10. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2018-08-10.