Organization Active NPI

Forward Care Management, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • High Point, NC
National Provider Identifier
1063430809
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL-041-591 Issued in NC
Legal business name
FORWARD CARE MANAGEMENT, INC.
Practice address
1209 Shalimar Dr
High Point, NC 27262-4598
Phone
(336) 475-8873
Fax
(336) 475-8874
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Teresa Hayes Amusan
Title
Executive Director
Phone
(336) 475-8873

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-041-591 NC Primary

Addresses

Primary practice location

1209 Shalimar Dr
High Point, NC 27262-4598

Mailing address

PO Box 393
High Point, NC 27261-0393
Phone (336) 475-8873

Other identifiers 1

IdentifierTypeStateIssuer
6603072MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063430809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272610393",
            "telephone_number": "336-475-8873",
            "fax_number": "336-475-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 SHALIMAR DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624598",
            "telephone_number": "336-475-8873",
            "fax_number": "336-475-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORWARD CARE MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMUSAN",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "HAYES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-475-8873",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-041-591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603072",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • 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.