Hines Family Services Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

HINES FAMILY SERVICES INC

Practice address

615 Saint George Square CT Ste 300
Winston Salem, NC 27103-1368

Phone

(336) 303-1263

NPI assigned

Jan 28, 2020

Last updated

Jul 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derrick Hines

Title

Ceo

Phone

(469) 353-9526

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1316578404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368",
            "telephone_number": "336-303-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HINES FAMILY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-353-9526"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Vernon Hillson, DNP
• Suzanne Elizabeth Hilton, MD
• Lauren Grace Himes
• Jessica Lynn Hinaman Destefano
• Molly Hinely, PHARMD, CPP
• Hines Good Samaritan Home
• Hines Good Samaritan Home
• Anne Creech Hines, M.D.
• Bethany Rose Pavlinchak Hines, MD
• Courtney Tysinger Hines, PHARMD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.