NPIMap

Organization Active NPI

Elite Adolescent Care, Inc.

Doing business as YouthSpring Residential Treatment

  • Psychiatric Residential Treatment Facility
  • Greensboro, NC
National Provider Identifier
1235401811
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
ELITE ADOLESCENT CARE, INC.
Doing business as
YouthSpring Residential Treatment
Practice address
4501 Old Battleground Rd
Greensboro, NC 27410-9352
Phone
(910) 483-0324
NPI assigned
Jan 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Authorized official

Name
Mr. Avery B. Green
Title
Ceo
Phone
(336) 763-7287

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Intellectual & Developmental Disabilities PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TM1800X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X
Community/Behavioral Health Agency 251S00000X
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

4501 Old Battleground Rd
Greensboro, NC 27410-9352

Mailing address

PO Box 38338
Greensboro, NC 27408-8338
Phone (336) 763-7287

Other identifiers 1

IdentifierTypeStateIssuer
6008846MedicaidNC

Other names 1

  • YouthSpring Residential Treatment Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elite Adolescent Care Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1235401811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38338",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088338",
            "telephone_number": "336-763-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 OLD BATTLEGROUND RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109352",
            "telephone_number": "910-483-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ADOLESCENT CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "AVERY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-763-7287",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008846",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YouthSpring Residential Treatment",
            "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 Dec 16, 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.