Carolina Correctional Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MHL-092-628 Issued in NC

Legal business name

CAROLINA CORRECTIONAL SERVICES, INC.

Doing business as

Wake Juvenile Day Treatment Center

Practice address

2940 Falstaff Rd
Raleigh, NC 27610-1840

Phone

(919) 231-9717

Fax

(919) 231-9754

NPI assigned

Oct 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeffery Todd Edwards, M.A. ED

Title

Administrator

Phone

(919) 754-9422

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wake Juvenile Day Treatment Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023105251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 FAYETTEVILLE STREET MALL",
            "address_2": "SUITE 505",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276011747",
            "telephone_number": "919-754-9422",
            "fax_number": "919-754-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 FALSTAFF RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101840",
            "telephone_number": "919-231-9717",
            "fax_number": "919-231-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CORRECTIONAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-754-9422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A. ED"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-092-628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301228",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wake Juvenile Day Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolina Community Mental Health Centers, Inc
• Carolina Comprehensive Service, LLC
• Carolina Comprehensive Services, LLC
• Carolina Comprehensive Services, LLC
• Carolina Conceptions, PA
• Carolina Counseling and Play Therapy, PLLC
• Carolina Counseling and Therapeutic Solutions
• Carolina Counseling Specialists, PLLC
• Carolina Diagnostic Labs LLC
• Carolina Diagnostics Inc

• Community/Behavioral Health Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.