Organization Active NPI

Adult Day&Respite Care Center

  • Adult Mental Health Clinic/Center
  • Greensboro, NC
National Provider Identifier
1124306865
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
MHL-076-099 Issued in NC
Legal business name
ADULT DAY&RESPITE CARE CENTER
Practice address
3107 Groometown Rd
Greensboro, NC 27407-5518
Phone
(336) 852-8338
Fax
(336) 852-8333
NPI assigned
Jul 29, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Joanne Cagle, MSW
Title
Executive Director
Phone
(336) 852-8338

National Provider Directory

National Provider Directory
Tax ID family
Adult Day Respite Care Center2 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.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MHL-076-099 NC Primary

Addresses

NPPES NPI Registry

Primary practice location

3107 Groometown Rd
Greensboro, NC 27407-5518

Mailing address

3107 Groometown Rd
N/a
Greensboro, NC 27407-5518
Phone (336) 852-8338

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3409220MedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 29, 2011.

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1124306865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 GROOMETOWN RD",
            "address_2": "N/A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075518",
            "telephone_number": "336-852-8338",
            "fax_number": "336-852-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 GROOMETOWN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075518",
            "telephone_number": "336-852-8338",
            "fax_number": "336-852-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT DAY&RESPITE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "CAGLE",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-852-8338",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL-076-099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409220",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.