NPIMap

Organization Active NPI

Vision Youth Group Home,Inc.

Doing business as Northwest Place

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Greensboro, NC
National Provider Identifier
1235291923
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL-041-147 Issued in NC
Legal business name
VISION YOUTH GROUP HOME,INC.
Doing business as
Northwest Place
Practice address
3415 Cottage PL
Greensboro, NC 27455-2019
Phone
(336) 288-7685
Fax
(336) 644-9254
NPI assigned
Dec 15, 2006
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Mr. Jimmy Guess, MSW,LCSWNPI 1235504283
Title
Executive Director
Phone
(336) 508-2203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-041-147 NC Primary

Addresses

Primary practice location

3415 Cottage PL
Greensboro, NC 27455-2019

Mailing address

6107 Bascom Dr
Summerfield, NC 27358-9119
Phone (336) 508-2203

Other identifiers 1

IdentifierTypeStateIssuer
6603097MedicaidNC

Other names 1

  • Northwest Place Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Banoyd Place3 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1235291923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 BASCOM DR",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589119",
            "telephone_number": "336-508-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 COTTAGE PL",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552019",
            "telephone_number": "336-288-7685",
            "fax_number": "336-644-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION YOUTH GROUP HOME,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "GUESS",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-508-2203",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW,LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-041-147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603097",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.