Organization Active NPI

The Mental Health Association in North Carolina, Inc.

Doing business as Waverly House

  • Mental Illness Community Based Residential Treatment Facility
  • Albemarle, NC
National Provider Identifier
1316160302
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL-084-016 Issued in NC
Legal business name
THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.
Doing business as
Waverly House
Practice address
2215 Waverly St
Albemarle, NC 28001
Phone
(704) 983-2777
NPI assigned
Apr 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kevin Cochran
Title
Financial Assistant
Phone
(919) 866-3287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-084-016 NC Primary

Addresses

Primary practice location

2215 Waverly St
Albemarle, NC 28001

Mailing address

1331 Sunday Dr
Raleigh, NC 27607-5166
Phone (919) 866-3287

Other identifiers 1

IdentifierTypeStateIssuer
7805042MedicaidNC

Other names 1

  • Waverly House Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316160302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 SUNDAY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276075166",
            "telephone_number": "919-866-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 WAVERLY ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "28001",
            "telephone_number": "704-983-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "FINANCIAL ASSISTANT",
        "authorized_official_telephone_number": "919-866-3287",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-084-016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805042",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waverly House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.