NPIMap

Organization Active NPI

Martin County Residential Services Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Williamston, NC
National Provider Identifier
1124168141
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
MHL058003 Issued in NC
Legal business name
MARTIN COUNTY RESIDENTIAL SERVICES INC.
Practice address
6003 West Main Street
Williamston, NC 27892
Phone
(252) 792-8251
Fax
(252) 792-5283
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Mrs. Becky Renn
Title
Executive Director
Phone
(252) 792-8251

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X MHL058002 NC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL058003 NC Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL058004 NC
Day Training/Habilitation SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 373H00000X MHL058002 NC
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X MHLO58003 NC
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X MHL058004 NC

Addresses

Primary practice location

6003 West Main Street
Williamston, NC 27892

Mailing address

PO Box 1042
Williamston, NC 27892-1042
Phone (252) 792-8251

Other names 1

  • Martin Enterprises Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Martin County Residential Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1124168141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1042",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278921042",
            "telephone_number": "252-792-8251",
            "fax_number": "252-792-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 WEST MAIN STREET",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "27892",
            "telephone_number": "252-792-8251",
            "fax_number": "252-792-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN COUNTY RESIDENTIAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "RENN",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-792-8251",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": "MHL058002",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL058003",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL058004",
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": "NC",
            "license": "MHL058002",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "NC",
            "license": "MHLO58003",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "NC",
            "license": "MHL058004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martin Enterprises",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.