Caroline Outpatient Program

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CAROLINE OUTPATIENT PROGRAM

Practice address

7120 Conway Place
Ruther Glen, VA 22546

Phone

(804) 305-5954

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sheronda W. Wingo

Title

Ceo/Director

Phone

(804) 589-0022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1346423225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 615",
            "city": "LADYSMITH",
            "state": "VA",
            "postal_code": "225010615",
            "telephone_number": "804-305-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 CONWAY PLACE",
            "city": "RUTHER GLEN",
            "state": "VA",
            "postal_code": "22546",
            "telephone_number": "804-305-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINE OUTPATIENT PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "WINGO",
        "authorized_official_first_name": "SHERONDA",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "804-589-0022",
        "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 Ruther Glen, VA
• Providers in Ruther Glen, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.