NPIMap

Organization Active NPI

Pearls Angel Care Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fayetteville, NC
National Provider Identifier
1609916816
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
6603332 Issued in NC
Legal business name
PEARLS ANGEL CARE INC.
Practice address
1423 Grandview Dr
Fayetteville, NC 28314-1805
Phone
(910) 257-6060
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Authorized official

Name
Ms. Betty Washington
Title
Director
Phone
(910) 257-6060

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6603332 NC
Mental Illness Community Based Residential Treatment Facility 320800000X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 6603332 NC Primary

Addresses

Primary practice location

1423 Grandview Dr
Fayetteville, NC 28314-1805

Mailing address

1545 Stackhouse Dr
Fayetteville, NC 28314-6356
Phone (910) 257-6060

Other identifiers 4

IdentifierTypeStateIssuer
6603332MedicaidNC
8301357BMedicaidNC
3418665MedicaidNC
8301357GMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pearls Angel Care Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1609916816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 STACKHOUSE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283146356",
            "telephone_number": "910-257-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 GRANDVIEW DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141805",
            "telephone_number": "910-257-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLS ANGEL CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-257-6060",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "6603332",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "6603332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603332",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301357B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418665",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301357G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.