A Sure House, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-034-207 Issued in NC

Legal business name

A SURE HOUSE, INC.

Practice address

1265 Arbor Rd
Winston Salem, NC 27104-1105

Phone

(336) 749-0264

Fax

(800) 314-7553

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Pamela Lavette Phillips

Title

Executive Director

Phone

(336) 749-0264

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1295887586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 ARBOR RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041105",
            "telephone_number": "336-749-0264",
            "fax_number": "800-314-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 ARBOR RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041105",
            "telephone_number": "336-749-0264",
            "fax_number": "800-314-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SURE HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "LAVETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-749-0264",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-034-207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.