NPIMap

Organization Active NPI

A Positive Life Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fayetteville, NC
National Provider Identifier
1033342258
Registry record updated Sep 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL-026742 Issued in NC
Legal business name
A POSITIVE LIFE INC
Practice address
3108 Dyke St
Fayetteville, NC 28306-2809
Phone
(910) 223-7300
Fax
(910) 323-3206
NPI assigned
Sep 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2009

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

Authorized official

Name
Mr. Walter Lee Young, BS
Title
Director/Owner
Phone
(910) 223-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-026742 NC Primary

Addresses

Primary practice location

3108 Dyke St
Fayetteville, NC 28306-2809

Mailing address

3108 Dyke St
Fayetteville, NC 28306-2809
Phone (910) 223-7300

Other identifiers 2

IdentifierTypeStateIssuer
6603408MedicaidNC
8301441MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
A Positive Life Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252022400000",
    "number": "1033342258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 DYKE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062809",
            "telephone_number": "910-223-7300",
            "fax_number": "910-323-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 DYKE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062809",
            "telephone_number": "910-223-7300",
            "fax_number": "910-323-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A POSITIVE LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-04",
        "last_updated": "2009-09-04",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "910-223-7300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-026742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603408",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301441",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; 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.