NPIMap

Organization Active NPI

Alcohol and Drug Services of Guilford, Inc.

  • Community/Behavioral Health Agency
  • High Point, NC
National Provider Identifier
1124166350
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-041-010 Issued in NC
Legal business name
ALCOHOL AND DRUG SERVICES OF GUILFORD, INC.
Practice address
119 Chestnut Dr
High Point, NC 27262-6803
Phone
(336) 882-2125
Fax
(336) 882-8153
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Mr. Ronald C. Rau Jr., MBA
Title
President
Phone
(336) 882-2125

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-041-010 NC Primary

Addresses

Primary practice location

119 Chestnut Dr
High Point, NC 27262-6803

Mailing address

301 E Washington St
Suite 101
Greensboro, NC 27401-2993
Phone (336) 333-6860

Other identifiers 6

IdentifierTypeStateIssuer
8301008BMedicaidNC
8301008MedicaidNC
6005602MedicaidNC
8301008GMedicaidNC
8301008TMedicaidNC
8301008QMedicaidNC

Other names 1

  • West Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120514000362 NC Part B Supplier - Clinic/Group Practice 2860655735 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
Practice locations: Asheboro, NC; Greensboro, NC; High Point, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0971488Alcohol Drug Services119 Chestnut Drive, High Point, NC 27262Certificate of waiverMar 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ads-Burlington7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

119 Chestnut Dr
High Point, NC 27262
Phone (336) 532-0500

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1124166350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012993",
            "telephone_number": "336-333-6860",
            "fax_number": "336-275-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CHESTNUT DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272626803",
            "telephone_number": "336-882-2125",
            "fax_number": "336-882-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALCOHOL AND DRUG SERVICES OF GUILFORD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "RAU",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-882-2125",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-041-010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301008B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301008",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005602",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301008G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301008T",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301008Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.