Matchbox Health Services Corporation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MATCHBOX HEALTH SERVICES CORPORATION

Practice address

203 N Main St Ste 216
Roxboro, NC 27573-5343

Phone

(336) 322-0657

Fax

(336) 322-0726

NPI assigned

Jul 23, 2008

Organization subpart

No

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

Authorized official

Name

Joann Long

Title

Executive Director

Phone

(336) 322-0657

Specialties & licenses 3

Addresses

Tax ID family

Matchbox Health Services Corporation2 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.

• MHS Unlimited,Corporation

  • Community/Behavioral Health Agency
  • Roxboro, NC
  • NPI 1558782797
  NPD tax ID

Locations

Practitioners 1

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

• David Kozak, MSW, LCSW-A

  • Clinical Social Worker
  • Roxboro, NC
  • NPI 1013512367
  NPD (past)

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1508021080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52660",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277172660",
            "telephone_number": "919-281-0153",
            "fax_number": "919-281-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N MAIN ST STE 216",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735343",
            "telephone_number": "336-322-0657",
            "fax_number": "336-322-0726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Consultant Pl",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277073598",
            "country_code": "US",
            "telephone_number": "919-281-0153",
            "fax_number": "919-281-0157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2310 S Miami Blvd Ste 139",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277034900",
            "country_code": "US",
            "telephone_number": "919-281-0153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MATCHBOX HEALTH SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "JOANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-322-0657"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Roxboro, NC
• Providers in Roxboro, 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 Jun 4, 2019; 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.