Back 2 Lyfe Outreach Services, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BACK 2 LYFE OUTREACH SERVICES, INC

Practice address

1914 J N Pease PL
Charlotte, NC 28262-4504

Phone

(980) 292-3213

NPI assigned

Jul 19, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Lashauna April Grier

Title

Program Director

Phone

(443) 286-7850

Specialties & licenses 2

Addresses

Other names 1

• Back 2 Lyfe Outreach Services Doing business as

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1114607637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 STOCK LN",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281159720",
            "telephone_number": "980-292-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 J N PEASE PL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624504",
            "telephone_number": "980-292-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK 2 LYFE OUTREACH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "GRIER",
        "authorized_official_first_name": "LASHAUNA",
        "authorized_official_middle_name": "APRIL",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "443-286-7850",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back 2 Lyfe Outreach Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Roberta Jo Backel, CRNP
• Madison Backer

• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, 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 Jul 27, 2023; 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.