NPIMap

Organization Active NPI

F.a.C.T. Specialized Services, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Jacksonville, NC
National Provider Identifier
1447331475
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL067133 Issued in NC
Legal business name
F.A.C.T. SPECIALIZED SERVICES, INC.
Practice address
109 Silverleaf Dr
Jacksonville, NC 28546-7360
Phone
(910) 353-1903
Fax
(910) 577-4568
NPI assigned
Oct 18, 2006
Last updated
Apr 22, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
THE METHODIST HOME FOR CHILDREN, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Authorized official

Name
Susan Winningham
Title
Qi Director
Phone
(910) 346-3744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL067133 NC Primary

Addresses

Primary practice location

109 Silverleaf Dr
Jacksonville, NC 28546-7360

Mailing address

109 Silverleaf Dr
Jacksonville, NC 28546-7360
Phone (910) 353-1903

Other identifiers 1

IdentifierTypeStateIssuer
6603236MedicaidNC

Other names 1

  • Silverleaf Lodge Other name

National Provider Directory

National Provider Directory
Tax ID family
Fact Specialized Services Inc6 organizations share this tax ID, including this one
Part of
The Methodist Home for Children Inc

Other organizations with this tax ID 5

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1447331475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SILVERLEAF DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467360",
            "telephone_number": "910-353-1903",
            "fax_number": "910-577-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SILVERLEAF DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467360",
            "telephone_number": "910-353-1903",
            "fax_number": "910-577-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F.A.C.T. SPECIALIZED SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE METHODIST HOME FOR CHILDREN, INC.",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "WINNINGHAM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "QI DIRECTOR",
        "authorized_official_telephone_number": "910-346-3744"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL067133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603236",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silverleaf Lodge",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.