NPIMap

Organization Active NPI

F.a.C.T. Specialized Services, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Jacksonville, NC
National Provider Identifier
1538244074
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL067101 Issued in NC
Legal business name
F.A.C.T. SPECIALIZED SERVICES, INC.
Practice address
107 Silverleaf Dr
Jacksonville, NC 28546-7360
Phone
(910) 577-4568
Fax
(910) 577-4568
NPI assigned
Oct 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lorna Kathleen Aschbrenner
Title
Director of Operations
Phone
(910) 346-3744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL067101 NC Primary

Addresses

Primary practice location

107 Silverleaf Dr
Jacksonville, NC 28546-7360

Mailing address

107 Silverleaf Dr
Jacksonville, NC 28546-7360
Phone (910) 577-4568

Other identifiers 1

IdentifierTypeStateIssuer
6603168MedicaidNC

Other names 1

  • Shadowridge Retreat Other name

National Provider Directory

National Provider Directory
Tax ID family
Fact Specialized Services Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538244074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SILVERLEAF DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467360",
            "telephone_number": "910-577-4568",
            "fax_number": "910-577-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SILVERLEAF DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467360",
            "telephone_number": "910-577-4568",
            "fax_number": "910-577-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F.A.C.T. SPECIALIZED SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASCHBRENNER",
        "authorized_official_first_name": "LORNA",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "910-346-3744"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL067101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603168",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shadowridge Retreat",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 22, 2020; 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.