A Broader Future, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2016-3437-01 Issued in NC

Legal business name

A BROADER FUTURE, INC

Doing business as

Creative community Options

Practice address

3444 Bragg Blvd
Fayetteville, NC 28303-3946

Phone

(910) 322-3001

NPI assigned

Jan 27, 2017

Last updated

Jan 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Andrea BroadnaxNPI 1508225160

Title

Executive Director

Phone

(910) 286-7873

Specialties & licenses 3

Addresses

Other names 1

• Creative community Options Doing business as

Locations

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.

• Andrea Broadnax

  • Private Vehicle
  • Fayetteville, NC
  • NPI 1508225160

  Community/Behavioral Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1235676248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 SOUTHVIEW CIR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283110318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 BRAGG BLVD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033946",
            "telephone_number": "910-322-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BROADER FUTURE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "BROADNAX",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-286-7873",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "2016-3437-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative community Options",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.