Active NPI
Reynolds Youth Services
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Forest City, NC
National Provider Identifier
1679606487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- License
- MHL-081-050
- Legal business name
- REYNOLDS YOUTH SERVICES
- Practice address
- 331 S Broadway St
Forest City, NC 28043-3648 - Phone
- (828) 247-4856
- Fax
- (828) 247-4857
- NPI assigned
- Mar 13, 2007
- Last updated
- Jun 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Phillip E Reynolds
- Title
- Owner Director
- Phone
- (828) 247-4856
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | MHL-081-050 | NC | Primary |
Addresses
Primary practice location
331 S Broadway St
Forest City, NC 28043-3648
Mailing address
331 S Broadway St
Forest City, NC 28043-3648
Phone (828) 247-4856
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6603937 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Reynolds Youth Services
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Forest City, NC
- NPI 1669505483
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Forest City, NC
- NPI 1730264938
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Columbus, NC
- NPI 1891981288
Locations
331 S Broadway St
Forest City, NC 28043
Phone (828) 247-0366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213142400000",
"number": "1679606487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 S BROADWAY ST",
"city": "FOREST CITY",
"state": "NC",
"postal_code": "280433648",
"telephone_number": "828-247-4856",
"fax_number": "828-247-4857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 S BROADWAY ST",
"city": "FOREST CITY",
"state": "NC",
"postal_code": "280433648",
"telephone_number": "828-247-4856",
"fax_number": "828-247-4857"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REYNOLDS YOUTH SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-13",
"last_updated": "2008-06-11",
"status": "A",
"authorized_official_last_name": "REYNOLDS",
"authorized_official_first_name": "PHILLIP",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "OWNER DIRECTOR",
"authorized_official_telephone_number": "828-247-4856"
},
"taxonomies": [
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "NC",
"license": "MHL-081-050",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6603937",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.