C&a Community Intervention Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

C&A COMMUNITY INTERVENTION SERVICES

Practice address

219 Belmont Dr
Raeford, NC 28376-8014

Phone

(901) 670-6567

Fax

(910) 904-2931

NPI assigned

Nov 2, 2007

Organization subpart

No

Name

Miss Angela Gail Southerland

Title

Executive Director/Medical Biller

Phone

(910) 670-6567

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 2, 2007.

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1548449986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 BELMONT DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283768014",
            "telephone_number": "901-670-6567",
            "fax_number": "910-904-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 BELMONT DR",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283768014",
            "telephone_number": "901-670-6567",
            "fax_number": "910-904-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C&A COMMUNITY INTERVENTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/MEDICAL BILLER",
        "authorized_official_telephone_number": "910-670-6567",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Raeford, NC
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.