NPIMap

Organization Active NPI

Tri County Community Health Council Inc

Doing business as CommWell House - Angelic House

  • Adult Mental Health Clinic/Center
  • Goldsboro, NC
National Provider Identifier
1154624054
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
TRI COUNTY COMMUNITY HEALTH COUNCIL INC
Doing business as
CommWell House - Angelic House
Practice address
1206 E Walnut St
Goldsboro, NC 27530-5161
Phone
(919) 735-1531
Fax
(910) 567-5022
NPI assigned
Dec 15, 2010
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
William C Ellison
Title
Revenue Cycle Manager
Phone
(910) 567-7065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1206 E Walnut St
Goldsboro, NC 27530-5161

Mailing address

PO Box 340
Four Oaks, NC 27524-0340
Phone (919) 735-1531

Other names 1

  • CommWell House - Angelic House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tri-Co Community HLTH Ctr30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1154624054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275240340",
            "telephone_number": "919-735-1531",
            "fax_number": "910-567-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E WALNUT ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275305161",
            "telephone_number": "919-735-1531",
            "fax_number": "910-567-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY COMMUNITY HEALTH COUNCIL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "910-567-7065"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CommWell House - Angelic House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.