Fokus Residential Services, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

001-235 Issued in NC

Legal business name

FOKUS RESIDENTIAL SERVICES, LLC

Practice address

411 Tillman St
Burlington, NC 27217-2358

Phone

(336) 350-8420

NPI assigned

Jan 23, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Keith Derrick Haith, BS

Title

Director

Phone

(336) 675-4713

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421971200000",
    "number": "1225428634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 JUNIPER DR",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272157934",
            "telephone_number": "336-270-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 TILLMAN ST",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172358",
            "telephone_number": "336-350-8420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOKUS RESIDENTIAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A",
        "authorized_official_last_name": "HAITH",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "DERRICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-675-4713",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "001-235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Loraine Flournoy, PTA
• Kori Bridget Flower, MD
• Sara Elizabeth Flynn, DPT
• Emily Louise Fogleman, MS, NCC, LCMHCA
• Elizabeth Nora Fojtik, MD
• Kimberly M Fonder, OTR/L
• Forward Journey PLLC
• Forward Path Recovery Support Services, LLC
• Bobby Fitzgerald Foster, CSAC-I
• Joynettia A Foster, LPC

• Mental Illness Community Based Residential Treatment Facility in Burlington, NC
• Providers in Burlington, NC by specialty
• Mental Illness Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.