Community Outreach Youth Services LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL-078-317 Issued in NC

Legal business name

COMMUNITY OUTREACH YOUTH SERVICES LLC

Practice address

177 Cardinal Ave
Lumberton, NC 28360-9386

Phone

(910) 827-0111

NPI assigned

Nov 10, 2016

Last updated

Jul 26, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Arlis Emanuel

Title

Ceo

Phone

(910) 827-0111

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501027200000",
    "number": "1659813335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 CARDINAL AVE",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283609386",
            "telephone_number": "910-827-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 CARDINAL AVE",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283609386",
            "telephone_number": "910-827-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY OUTREACH YOUTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2017-07-26",
        "status": "A",
        "authorized_official_last_name": "EMANUEL",
        "authorized_official_first_name": "ARLIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-827-0111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-078-317",
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Mental Illness 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 Jul 26, 2017; 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.