NPIMap

Organization Active NPI

A Positive Life

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fayetteville, NC
National Provider Identifier
1326186578
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL026742 Issued in NC
Legal business name
A POSITIVE LIFE
Practice address
6033 Concho CT
Fayetteville, NC 28303-2509
Phone
(910) 480-2555
Fax
(910) 323-3206
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Authorized official

Name
Mr. Walter Young, BS
Title
Director
Phone
(910) 223-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL026742 NC Primary

Addresses

Primary practice location

6033 Concho CT
Fayetteville, NC 28303-2509

Mailing address

351 Wagoner Dr
Fayetteville, NC 28303-4608
Phone (910) 223-7300

Other identifiers 1

IdentifierTypeStateIssuer
6603408MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
A Positive Life Inc5 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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1326186578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 WAGONER DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034608",
            "telephone_number": "910-223-7300",
            "fax_number": "910-323-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 CONCHO CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283032509",
            "telephone_number": "910-480-2555",
            "fax_number": "910-323-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A POSITIVE LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-223-7300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL026742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603408",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.