NPIMap

Organization Active NPI

Potter's House Outreach Corporation

  • Community/Behavioral Health Agency
  • Fayetteville, NC
National Provider Identifier
1457682452
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
POTTER'S HOUSE OUTREACH CORPORATION
Practice address
603 Country Club Drive
Fayetteville, NC 28301-7686
Phone
(910) 904-5791
Fax
(910) 904-6791
NPI assigned
Jan 15, 2010
Last updated
Jan 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Authorized official

Name
Mr. Vincent Robinson
Title
Ceo
Phone
(910) 904-5791

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

603 Country Club Drive
Fayetteville, NC 28301-7686

Mailing address

P.O. Box 26073
Fayetteville, NC 28314-5017
Phone (910) 904-5791

National Provider Directory

National Provider Directory
Tax ID family
Potter's House Outreach Corporation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

603 Country Club Dr
Fayetteville, NC 28301
Phone (910) 904-5791

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263513600000",
    "number": "1457682452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 26073",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145017",
            "telephone_number": "910-904-5791",
            "fax_number": "910-904-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 COUNTRY CLUB DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283017686",
            "telephone_number": "910-904-5791",
            "fax_number": "910-904-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTER'S HOUSE OUTREACH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-904-5791",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.