Invincible Community Based Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

C200815700098 Issued in NC

Legal business name

INVINCIBLE COMMUNITY BASED SERVICES LLC

Practice address

1015 Roanoke Ave Ste a
Roanoke Rapids, NC 27870-3721

Phone

(252) 541-1576

Fax

(252) 541-1577

NPI assigned

Oct 9, 2008

Last updated

Oct 9, 2008By 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

Ms. Katrina Laverne Macklin, B.S.

Title

Owner; Qualified Professional

Phone

(252) 541-1576

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1386895159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 ROANOKE AVE STE A",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703721",
            "telephone_number": "252-541-1576",
            "fax_number": "252-541-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 ROANOKE AVE STE A",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703721",
            "telephone_number": "252-541-1576",
            "fax_number": "252-541-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INVINCIBLE COMMUNITY BASED SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "MACKLIN",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "LAVERNE",
        "authorized_official_title_or_position": "OWNER; QUALIFIED PROFESSIONAL",
        "authorized_official_telephone_number": "252-541-1576",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "C200815700098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.