NPIMap

Organization Active NPI

Our Fathers Place Inc

  • Community/Behavioral Health Agency
  • Statesville, NC
National Provider Identifier
1679741714
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
OUR FATHERS PLACE INC
Practice address
256 East Broad Street
Statesville, NC 28677-5325
Phone
(704) 872-0313
Fax
(704) 872-0535
NPI assigned
Feb 12, 2008
Last updated
Feb 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Mr. James Russell Linton, MASTER OF EDUCATION
Title
Chief Executive Officer
Phone
(704) 684-0197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

256 East Broad Street
Statesville, NC 28677-5325

Mailing address

256 East Broad Street
Statesville, NC 28677-5325
Phone (704) 872-0313

National Provider Directory

National Provider Directory
Tax ID family
Our Fathers Place Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1202774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1679741714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 EAST BROAD STREET",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775325",
            "telephone_number": "704-872-0313",
            "fax_number": "704-872-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 EAST BROAD STREET",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286775325",
            "telephone_number": "704-872-0313",
            "fax_number": "704-872-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR FATHERS PLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "LINTON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "704-684-0197",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTER OF EDUCATION"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

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

Verify at the official NPI Registry.