Open Door MGMT Agency of Jacksonville

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

OPEN DOOR MGMT AGENCY OF JACKSONVILLE

Practice address

1675 Halltown Rd
Jacksonville, NC 28546-4565

Phone

(910) 346-7513

Fax

(910) 346-9431

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Delores Perry

Title

Owner

Phone

(910) 577-4175

Specialties & licenses 1

Addresses

Tax ID family

Open Door MGMT Agency of Jacksonville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Trinity Adult Care Home

  • Adult Care Home Facility
  • Maysville, NC
  • NPI 1205082187
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Earnest Andrew Perry Sr.

  • Specialist
  • Jacksonville, NC
  • NPI 1861612806
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1326193186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 LYNCHBURG DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466010",
            "telephone_number": "910-577-4175",
            "fax_number": "910-455-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 HALLTOWN RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285464565",
            "telephone_number": "910-346-7513",
            "fax_number": "910-346-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR MGMT AGENCY OF JACKSONVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "DELORES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-577-4175",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.