NPIMap

Organization Active NPI

Southern Cross Community Services, Inc

Doing business as Southern Cross Mental Health Centers

  • Community/Behavioral Health Agency
  • Wilmington, NC
National Provider Identifier
1316062862
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
3756 Issued in NC
Legal business name
SOUTHERN CROSS COMMUNITY SERVICES, INC
Doing business as
Southern Cross Mental Health Centers
Practice address
2202 Wrightsville Avenue
Suite 114
Wilmington, NC 28403-2406
Phone
(910) 763-3773
Fax
(910) 763-3799
NPI assigned
Mar 20, 2007
Last updated
Jun 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Authorized official

Name
Mr. William Dale Hudson Sr.
Title
President/Ceo
Phone
(843) 716-6000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Public Health or Welfare Agency 251K00000X NU
Community/Behavioral Health Agency 251S00000X 3756 NC Primary

Addresses

Primary practice location

2202 Wrightsville Avenue
Suite 114
Wilmington, NC 28403-2406

Mailing address

PO Box 656
Tabor City, NC 28463-0656
Phone (843) 716-6000

Other identifiers 3

IdentifierTypeStateIssuer
8301907MedicaidNC
8301907BMedicaidNC
8301907GMedicaidNC

Other names 1

  • Southern Cross Mental Health Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Cross Community Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1316062862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 656",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284630656",
            "telephone_number": "843-716-6000",
            "fax_number": "843-716-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 WRIGHTSVILLE AVENUE",
            "address_2": "SUITE 114",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032406",
            "telephone_number": "910-763-3773",
            "fax_number": "910-763-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CROSS COMMUNITY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "843-716-6000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "3756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301907",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301907B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301907G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Cross Mental Health Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.