Imperative Changes Outreach

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

IMPERATIVE CHANGES OUTREACH

Practice address

1710 W Third St
Greenville, NC 27834-1669

Phone

(252) 367-1112

NPI assigned

Dec 2, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Andre Gay

Title

Executive Director

Phone

(252) 367-1112

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385942400000",
    "number": "1285065243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278350553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W THIRD ST",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278341669",
            "telephone_number": "252-367-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERATIVE CHANGES OUTREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2013-12-02",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "252-367-1112",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; 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.