G.O.R.E. Community Development Corporation, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

8700383 Issued in NC

Legal business name

G.O.R.E. COMMUNITY DEVELOPMENT CORPORATION, INC.

Practice address

2118 Breezewood Dr
Charlotte, NC 28262-1403

Phone

(704) 549-1953

Fax

(704) 549-1968

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Stella Hall Reid

Title

Executive Director

Phone

(704) 549-1953

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1235267360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 BREEZEWOOD DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621403",
            "telephone_number": "704-549-1953",
            "fax_number": "704-549-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 BREEZEWOOD DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621403",
            "telephone_number": "704-549-1953",
            "fax_number": "704-549-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G.O.R.E. COMMUNITY DEVELOPMENT CORPORATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "HALL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-549-1953",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "8700383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8700383",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.