NPIMap

Organization Active NPI

Carolina Residential Services, Inc.

  • Community/Behavioral Health Agency
  • Goldsboro, NC
National Provider Identifier
1619242518
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL-096-005 Issued in NC
Legal business name
CAROLINA RESIDENTIAL SERVICES, INC.
Practice address
714 Simmons St
Goldsboro, NC 27530-3843
Phone
(919) 580-0020
Fax
(919) 580-0026
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Authorized official

Name
Susan M Kincaid
Title
Director/Owner
Phone
(828) 413-3786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-096-005 NC Primary

Addresses

Primary practice location

714 Simmons St
Goldsboro, NC 27530-3843

Mailing address

PO Box 286
Rutherford College, NC 28671-0286
Phone (828) 572-2333

Other identifiers 1

IdentifierTypeStateIssuer
8303429SMedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Carolina Residential Services Inc42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Locations

714 Simmons St
Goldsboro, NC 27530
Phone (919) 580-0020

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1619242518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 286",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "286710286",
            "telephone_number": "828-572-2333",
            "fax_number": "980-225-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 SIMMONS ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303843",
            "telephone_number": "919-580-0020",
            "fax_number": "919-580-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "KINCAID",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "828-413-3786"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-096-005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8303429S",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.