NPIMap

Organization Active NPI

Cottage Health Care Services, Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Raleigh, NC
National Provider Identifier
1487975074
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
MHI-092-777 Issued in NC
Legal business name
COTTAGE HEALTH CARE SERVICES, INC
Practice address
3826 Bland Rd Ste 200
Raleigh, NC 27609-6239
Phone
(919) 872-1441
Fax
(919) 872-1455
NPI assigned
Jun 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Authorized official

Name
Mr. Obiorah Anachuna
Title
Ceo
Phone
(919) 872-1441

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X MHI-092-777 NC
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Adult Day Care Clinic/Center 261QA0600X MHI-092-777 NC
Developmental Disabilities Clinic/Center 261QD1600X MHI-092-777 NC
Adult Mental Health Clinic/Center 261QM0850X MHI-092-777 NC
Adolescent and Children Mental Health Clinic/Center 261QM0855X MHI-092-777 NC Primary

Addresses

Primary practice location

3826 Bland Rd Ste 200
Raleigh, NC 27609-6239

Mailing address

3826 Bland Rd
Raleigh, NC 27609-6239
Phone (919) 872-1441

Other identifiers 3

IdentifierTypeStateIssuer
193200000XMedicaidNC
103TC2200XMedicaidNC
103TC1900XMedicaidNC

National Provider Directory

National Provider Directory

Locations

3200 Wake Forest Rd
Ste 200
Raleigh, NC 27609
Phone (919) 872-1441

3826 Bland Rd
Ste 200
Raleigh, NC 27609
Phone (919) 872-1441

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1487975074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3826 BLAND RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096239",
            "telephone_number": "919-872-1441",
            "fax_number": "919-872-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3826 BLAND RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096239",
            "telephone_number": "919-872-1441",
            "fax_number": "919-872-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTAGE HEALTH CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-17",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "ANACHUNA",
        "authorized_official_first_name": "OBIORAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-872-1441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "MHI-092-777",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NC",
            "license": "MHI-092-777",
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NC",
            "license": "MHI-092-777",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHI-092-777",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NC",
            "license": "MHI-092-777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193200000X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103TC2200X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103TC1900X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.