Square One Wellness Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SQUARE ONE WELLNESS CENTER, INC.

Practice address

1804 Martin Luther King Pkwy Ste 111
Durham, NC 27707-3587

Phone

(704) 956-3062

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Demetrius Crayton, B.A.

Title

Ed

Phone

(704) 956-3062

Specialties & licenses 3

Addresses

Tax ID family

Britton and Crump Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Britton and Crump Inc

  • Community/Behavioral Health Agency
  • Varnville, SC
  • NPI 1720483878
  NPD tax ID

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1467525873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 MARTIN LUTHER KING PKWY STE 111",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073587",
            "telephone_number": "704-956-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 MARTIN LUTHER KING PKWY STE 111",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073587",
            "telephone_number": "704-956-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUARE ONE WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "CRAYTON",
        "authorized_official_first_name": "DEMETRIUS",
        "authorized_official_title_or_position": "ED",
        "authorized_official_telephone_number": "704-956-3062",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.A."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Springdaile Assisted Living Inc
• Julia Vivian Springer, LCSWA
• Patricia Spells Springs, LPN
• Charles Edward Spritzer, M.D.
• Robert Frank Spurney, M.D.
• SRFC, Inc.
• Keeravaani Mukhil Srinivasan
• Roshini Srinivasan, MD
• Meredith Kathleen Srour-Welser, MD
• SSC Durham Operating Company LLC

• Community/Behavioral Health Agency in Durham, NC
• Providers in Durham, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.