NPIMap

Organization Active NPI

Murray Adolescent Training &TX Academy

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Charlotte, NC
National Provider Identifier
1225159676
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
065181 Issued in NC
Legal business name
MURRAY ADOLESCENT TRAINING &TX ACADEMY
Practice address
2012 Commonwealth Ave
Charlotte, NC 28205-5022
Phone
(704) 372-4915
Fax
(704) 372-4917
NPI assigned
Apr 3, 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
Mrs. Cynthia S Murray
Title
Vice President
Phone
(704) 372-4915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 065181 NC Primary

Addresses

Primary practice location

2012 Commonwealth Ave
Charlotte, NC 28205-5022

Mailing address

2012 Commonwealth Ave
Charlotte, NC 28205-5022
Phone (704) 372-4915

Other identifiers 1

IdentifierTypeStateIssuer
6603795MedicaidNC

Other names 1

  • Peaceful Dominion Group Home Other name

National Provider Directory

National Provider Directory
Tax ID family
Murray Adolescent Training TX Academy Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225159676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 COMMONWEALTH AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055022",
            "telephone_number": "704-372-4915",
            "fax_number": "704-372-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 COMMONWEALTH AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055022",
            "telephone_number": "704-372-4915",
            "fax_number": "704-372-4917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MURRAY ADOLESCENT TRAINING &TX ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "704-372-4915",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "065181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603795",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peaceful Dominion Group Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charlotte, 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.