NPIMap

Organization Active NPI

The John Oliver Center 2

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Goldsboro, NC
National Provider Identifier
1164629721
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL096130 Issued in NC
Legal business name
THE JOHN OLIVER CENTER 2
Practice address
102 Whitfield Dr
Goldsboro, NC 27530-4630
Phone
(919) 735-5602
Fax
(919) 735-9745
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John H Oliver Jr.
Title
Executive Director
Phone
(919) 739-5859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL096130 NC Primary

Addresses

Primary practice location

102 Whitfield Dr
Goldsboro, NC 27530-4630

Mailing address

PO Box 1504
Goldsboro, NC 27533-1504
Phone (919) 735-5602

Other identifiers 1

IdentifierTypeStateIssuer
6603619MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
The John Oliver Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164629721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1504",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275331504",
            "telephone_number": "919-735-5602",
            "fax_number": "919-735-9745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WHITFIELD DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304630",
            "telephone_number": "919-735-5602",
            "fax_number": "919-735-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JOHN OLIVER CENTER 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-739-5859",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL096130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603619",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.