NPIMap

Organization Active NPI

Diverse Care Services, LLC

  • Health Service Clinic/Center
  • Mount Ulla, NC
National Provider Identifier
1023340205
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
DIVERSE CARE SERVICES, LLC
Practice address
1485 Childers Road
Mount Ulla, NC 28125
Phone
(704) 664-5557
NPI assigned
Feb 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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

Authorized official

Name
Ms. Cynthia Louise McCoy
Title
Chief Executive Officer
Phone
(704) 664-5557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NC Primary

Addresses

Primary practice location

1485 Childers Road
Mount Ulla, NC 28125

Mailing address

1275 Relative Road
Post Office Box 654
Mount Ulla, NC 28125
Phone (704) 664-5557

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1023340205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 RELATIVE ROAD",
            "address_2": "POST OFFICE BOX 654",
            "city": "MOUNT ULLA",
            "state": "NC",
            "postal_code": "28125",
            "telephone_number": "704-664-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 CHILDERS ROAD",
            "city": "MOUNT ULLA",
            "state": "NC",
            "postal_code": "28125",
            "telephone_number": "704-664-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSE CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "704-664-5557",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Ulla, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.