NPIMap

Organization Active NPI

K D Support Services / Kelly'S Care

  • Psychiatric Residential Treatment Facility
  • Forest City, NC
National Provider Identifier
1306205398
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
K D SUPPORT SERVICES / KELLY'S CARE
Practice address
158 US Highway 221a
Forest City, NC 28043-5600
Phone
(828) 245-8223
Fax
(828) 245-4099
NPI assigned
Feb 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Authorized official

Name
Mr. Kenneth Dellinger, BS;QP
Title
Director of Operations
Phone
(828) 245-4011

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Mental Illness Community Based Residential Treatment Facility 320800000X
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

158 US Highway 221a
Forest City, NC 28043-5600

Mailing address

158 US Highway 221a
Forest City, NC 28043-5600
Phone (828) 245-4011

Other identifiers 1

IdentifierTypeStateIssuer
3418462MedicaidNC

Other names 1

  • Kellys Care 6 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
KD Support Services9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1306205398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 US HIGHWAY 221A",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280435600",
            "telephone_number": "828-245-4011",
            "fax_number": "828-245-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 US HIGHWAY 221A",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280435600",
            "telephone_number": "828-245-8223",
            "fax_number": "828-245-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K D SUPPORT SERVICES / KELLY'S CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "DELLINGER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "828-245-4011",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS;QP"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418462",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kellys Care 6",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forest City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.