NPIMap

Organization Active NPI

Myriad Support Center Incorporated

  • Community/Behavioral Health Agency
  • Winston Salem, NC
National Provider Identifier
1306039904
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MYRIAD SUPPORT CENTER INCORPORATED
Practice address
3500 Vest Mill Rd
Suite 9
Winston Salem, NC 27103-2978
Phone
(336) 896-2550
Fax
(336) 217-8009
NPI assigned
Aug 27, 2007
Last updated
Jul 8, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
SURRENT CAPITAL INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
Mr. Yussef Lateef Gilkey
Title
Executive Director
Phone
(336) 896-2550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3500 Vest Mill Rd
Suite 9
Winston Salem, NC 27103-2978

Mailing address

3500 Vest Mill Rd
Suite 9
Winston Salem, NC 27103-2978
Phone (336) 890-2550

National Provider Directory

National Provider Directory
Tax ID family
Myriad Support Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3500 Vest Mill Rd
Ste 9
Winston Salem, NC 27103
Phone (336) 896-2550

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1306039904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 VEST MILL RD",
            "address_2": "SUITE 9",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032978",
            "telephone_number": "336-890-2550",
            "fax_number": "336-217-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 VEST MILL RD",
            "address_2": "SUITE 9",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032978",
            "telephone_number": "336-896-2550",
            "fax_number": "336-217-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRIAD SUPPORT CENTER INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SURRENT CAPITAL INCORPORATED",
        "enumeration_date": "2007-08-27",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "GILKEY",
        "authorized_official_first_name": "YUSSEF",
        "authorized_official_middle_name": "LATEEF",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-896-2550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.