NPIMap

Organization Active NPI

Carolina Residential Services, Inc

  • Community/Behavioral Health Agency
  • Clinton, NC
National Provider Identifier
1104969989
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-082-007 Issued in NC
Legal business name
CAROLINA RESIDENTIAL SERVICES, INC
Practice address
307 Giddens St
Clinton, NC 28328-3413
Phone
(910) 299-5032
Fax
(910) 299-5033
NPI assigned
Feb 14, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ms. Susan M Kincaid
Title
Director
Phone
(828) 572-2333

National Provider Directory

National Provider Directory
Tax ID family
Carolina Residential Services Inc42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-082-007 NC Primary

Addresses

NPPES NPI Registry

Primary practice location

307 Giddens St
Clinton, NC 28328-3413

Mailing address

PO Box 286
Rutherford College, NC 28671-0286
Phone (828) 572-2333

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
8303431SMedicaidNC
8301235SMedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 22, 2012.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1104969989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 286",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "286710286",
            "telephone_number": "828-572-2333",
            "fax_number": "980-225-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 GIDDENS ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283283413",
            "telephone_number": "910-299-5032",
            "fax_number": "910-299-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA RESIDENTIAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "KINCAID",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "828-572-2333",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-082-007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303431S",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301235S",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.