NPIMap

Organization Active NPI

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

  • Community/Behavioral Health Agency
  • Jacksonville, NC
National Provider Identifier
1447335989
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL067140 Issued in NC
Legal business name
F.A.C.T. SPECIALIZED SERVICES, LLC
Practice address
120 Henderson Dr Ste a&B
Jacksonville, NC 28540-5602
Phone
(910) 346-3744
Fax
(910) 346-5344
NPI assigned
Oct 25, 2006
Last updated
Oct 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Authorized official

Name
Susan Frankfort
Title
Qi Director
Phone
(919) 754-3638

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL067140 NC Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL067101 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL067133 NC

Addresses

Primary practice location

120 Henderson Dr Ste a&B
Jacksonville, NC 28540-5602

Mailing address

1041 Washington St
Raleigh, NC 27605-1259
Phone (919) 833-2834

Other identifiers 3

IdentifierTypeStateIssuer
6604447MedicaidNC
6604445MedicaidNC
8303287RMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Fact Specialized Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

120 Henderson Dr
Ste Ab
Jacksonville, NC 28540
Phone (910) 346-3744

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1447335989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 WASHINGTON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051259",
            "telephone_number": "919-833-2834",
            "fax_number": "919-755-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HENDERSON DR STE A&B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405602",
            "telephone_number": "910-346-3744",
            "fax_number": "910-346-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F.A.C.T. SPECIALIZED SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "FRANKFORT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "QI DIRECTOR",
        "authorized_official_telephone_number": "919-754-3638"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL067140",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL067101",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL067133",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604447",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604445",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303287R",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 14, 2021; 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.