NPIMap

Organization Active NPI

Partnership for a Drug Free NC Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mooresville, NC
National Provider Identifier
1417125121
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PARTNERSHIP FOR A DRUG FREE NC INC
Practice address
610 E Center Ave
2ND Floor
Mooresville, NC 28115-2578
Phone
(704) 660-1020
NPI assigned
Feb 15, 2008
Last updated
Feb 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Authorized official

Name
Jeffrey Matkins
Title
Chief Operating Officer
Phone
(336) 714-3367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

610 E Center Ave
2ND Floor
Mooresville, NC 28115-2578

Mailing address

665 W 4TH St
Winston Salem, NC 27101-2701

Other identifiers 1

IdentifierTypeStateIssuer
5904283MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Insight Human Services24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

610 E Center Ave
Fl 2
Mooresville, NC 28115
Phone (704) 660-1020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1417125121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 W 4TH ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E CENTER AVE",
            "address_2": "2ND FLOOR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152578",
            "telephone_number": "704-660-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERSHIP FOR A DRUG FREE NC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "MATKINS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "336-714-3367"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904283",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.