Outreach Residential Services

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-082-069 Issued in NC

Legal business name

OUTREACH RESIDENTIAL SERVICES

Doing business as

OUTREACH RESIDENTIAL SERVICES

Practice address

3520 Maxwell Rd
Autryville, NC 28318-8785

Phone

(910) 423-1855

NPI assigned

Nov 16, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard Alexander Freeman

Title

Owner

Phone

(910) 423-1855

Specialties & licenses 1

Addresses

Other names 1

• OUTREACH RESIDENTIAL SERVICES Doing business as

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1437330560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5304 HUB JOHNSON RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283487820",
            "telephone_number": "910-423-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 MAXWELL RD",
            "city": "AUTRYVILLE",
            "state": "NC",
            "postal_code": "283188785",
            "telephone_number": "910-423-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-423-1855",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-082-069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OUTREACH RESIDENTIAL SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Autryville, NC
• Providers in Autryville, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.