NPIMap

Organization Active NPI

People of Potential, Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jacksonville, NC
National Provider Identifier
1124132030
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PEOPLE OF POTENTIAL, INC
Practice address
113 Courtland Dr
Jacksonville, NC 28546-6017
Phone
(910) 265-1756
Fax
(910) 265-1756
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Authorized official

Name
Ms. Dawn L McCullen
Title
Director
Phone
(910) 265-1756

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NC
Community/Behavioral Health Agency 251S00000X NC
Mental Illness Community Based Residential Treatment Facility 320800000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

113 Courtland Dr
Jacksonville, NC 28546-6017

Mailing address

113 Courtland Dr
Jacksonville, NC 28546-6017
Phone (910) 265-1756

Other identifiers 2

IdentifierTypeStateIssuer
3409608MedicaidNC
8301274MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
People of Potential 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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1124132030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 COURTLAND DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466017",
            "telephone_number": "910-265-1756",
            "fax_number": "910-265-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 COURTLAND DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466017",
            "telephone_number": "910-265-1756",
            "fax_number": "910-265-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEOPLE OF POTENTIAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "MCCULLEN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-265-1756",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409608",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301274",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.