NPIMap

Organization Active NPI

Professional Group Living, LLC

  • Community/Behavioral Health Agency
  • Goldsboro, NC
National Provider Identifier
1174705875
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROFESSIONAL GROUP LIVING, LLC
Practice address
122 S Center St
Goldsboro, NC 27530-4829
Phone
(919) 688-0818
NPI assigned
Dec 4, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Ms. Natalka Aquinairia Lock
Title
Executive Director
Phone
(919) 688-0818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

122 S Center St
Goldsboro, NC 27530-4829

Mailing address

122 S Center St
Goldsboro, NC 27530-4829
Phone (919) 688-0818

National Provider Directory

National Provider Directory
Tax ID family
Professional Group Living LLC11 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.

Locations

122 S Center St
Goldsboro, NC 27530
Phone (919) 688-0818

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1174705875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S CENTER ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304829",
            "telephone_number": "919-688-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S CENTER ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304829",
            "telephone_number": "919-688-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL GROUP LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "LOCK",
        "authorized_official_first_name": "NATALKA",
        "authorized_official_middle_name": "AQUINAIRIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-688-0818",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 4, 2007; 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.