NPIMap

Organization Active NPI

Directcare Community Base Services,LLC

  • Case Management Agency
  • Winston Salem, NC
National Provider Identifier
1124304753
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
DIRECTCARE COMMUNITY BASE SERVICES,LLC
Practice address
4401 Providence LN
Winston Salem, NC 27106-3226
Phone
(336) 397-9983
NPI assigned
Oct 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Mr. Barrance Todd Roberts
Title
Owner
Phone
(828) 305-4330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

4401 Providence LN
Winston Salem, NC 27106-3226

Mailing address

PO Box 261
Crouse, NC 28033-0261

Other names 1

  • mental health Other name

National Provider Directory

National Provider Directory
Tax ID family
Directcare Community Base Servicesllc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1124304753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261",
            "city": "CROUSE",
            "state": "NC",
            "postal_code": "280330261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 PROVIDENCE LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063226",
            "telephone_number": "336-397-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECTCARE COMMUNITY BASE SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "BARRANCE",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-305-4330",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mental health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.