NPIMap

Organization Active NPI

Pro Kids Youth and Family Service

  • Case Management Agency
  • Gastonia, NC
National Provider Identifier
1336333558
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PRO KIDS YOUTH AND FAMILY SERVICE
Practice address
2559 Quail Ridge Dr
Gastonia, NC 28056-9205
Phone
(704) 674-5455
NPI assigned
Aug 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Authorized official

Name
Mr. Demise Lamaar Williams
Title
Ceo
Phone
(704) 674-5455

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NC Primary
Community/Behavioral Health Agency 251S00000X NC

Addresses

Primary practice location

2559 Quail Ridge Dr
Gastonia, NC 28056-9205

Mailing address

2559 Quail Ridge Dr
Gastonia, NC 28056-9205
Phone (704) 674-5455

National Provider Directory

National Provider Directory
Tax ID family
Pro Kids Youth and Family Service2 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.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1336333558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2559 QUAIL RIDGE DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280569205",
            "telephone_number": "704-674-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2559 QUAIL RIDGE DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280569205",
            "telephone_number": "704-674-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO KIDS YOUTH AND FAMILY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DEMISE",
        "authorized_official_middle_name": "LAMAAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-674-5455",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

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