Azimuth Care Srevices

Primary specialty

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

License

017-021 Issued in NC

Legal business name

AZIMUTH CARE SREVICES

Practice address

2474 Camp Springs Rd
Reidsville, NC 27320-0146

Phone

(336) 342-9094

NPI assigned

Jan 20, 2010

Last updated

Jan 20, 2010By 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

Elinor Blackwell

Title

Program Director

Phone

(336) 540-9089

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1669703260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 STILL RUN DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274559229",
            "telephone_number": "336-540-9089",
            "fax_number": "336-540-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 CAMP SPRINGS RD",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273200146",
            "telephone_number": "336-342-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZIMUTH CARE SREVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "ELINOR",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "336-540-9089"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "017-021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Everardo Aviles Ruiz, MSW, LCSW, LCAS
• Gloria Zarwolo Bacchus
• Catherine T. Bailey
• James J Baker, DDS
• James Scott Baker, PHARMD
• Brittney Barbour, PTA

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Reidsville, NC
• Providers in Reidsville, NC by specialty
• 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 Jan 20, 2010; 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.