NPIMap

Organization Active NPI

Malachi Behavioral Healthcare,Inc

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Jacksonville, NC
National Provider Identifier
1508006479
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
Legal business name
MALACHI BEHAVIORAL HEALTHCARE,INC
Practice address
200 Valencia Dr
Suite 102&103
Jacksonville, NC 28546-6311
Phone
(910) 353-7600
Fax
(910) 353-7603
NPI assigned
Mar 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Ms. Shannette Monique Gray
Title
Owner
Phone
(910) 353-7600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X NC Primary

Addresses

Primary practice location

200 Valencia Dr
Suite 102&103
Jacksonville, NC 28546-6311

Mailing address

200 Valencia Dr
Suite 102&103
Jacksonville, NC 28546-6311
Phone (910) 353-7600

National Provider Directory

National Provider Directory
Tax ID family
Malachi Behavioral Healthcare Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

200 Valencia Dr
Ste 102103
Jacksonville, NC 28546
Phone (910) 353-7600

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1508006479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR",
            "address_2": "SUITE 102&103",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466311",
            "telephone_number": "910-353-7600",
            "fax_number": "910-353-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR",
            "address_2": "SUITE 102&103",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466311",
            "telephone_number": "910-353-7600",
            "fax_number": "910-353-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALACHI BEHAVIORAL HEALTHCARE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "SHANNETTE",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-353-7600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 4, 2009; 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.