Southwood Place Group and Developmental Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHWOOD PLACE GROUP AND DEVELOPMENTAL CENTER, INC.

Practice address

1407 Southwood PL
Monroe, NC 28112-6370

Phone

(704) 283-3099

NPI assigned

Feb 22, 2007

Last updated

Jul 21, 2008By 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. Annie A Ivey

Title

Executive Director

Phone

(704) 283-3099

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1265567259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281110396",
            "telephone_number": "704-283-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 SOUTHWOOD PL",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281126370",
            "telephone_number": "704-283-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWOOD PLACE GROUP AND DEVELOPMENTAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-283-3099",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409555",
            "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 Jul 21, 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.