Pride in North Carolina, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PRIDE IN NORTH CAROLINA, LLC

Practice address

2416 Bedgood Drive
Wilson, NC 27893-8515

Phone

(252) 265-9200

Fax

(252) 237-8600

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jason Rutski

Title

Director of Business Operations

Phone

(910) 452-1460

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Pride in North Carolina, Inc Former legal business name

Tax ID family

Pride in North Carolina Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Pride in North Carolina, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Elizabeth City, NC
  • NPI 1891850194
  NPD tax ID
• Pride in North Carolina, LLC

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1144368804
  NPD tax ID
• Pride in North Carolina, LLC

  • Community/Behavioral Health Agency
  • Elizabeth City, NC
  • NPI 1902944671
  NPD tax ID

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1043365869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 COMMERCE ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585029",
            "telephone_number": "252-321-8080",
            "fax_number": "252-321-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 BEDGOOD DRIVE",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278938515",
            "telephone_number": "252-265-9200",
            "fax_number": "252-237-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE IN NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "RUTSKI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "910-452-1460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300246",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300246G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300246B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride in North Carolina, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Wilson, NC
• Providers in Wilson, 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 Oct 4, 2017; 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.