NPIMap

Organization Active NPI

Pelham Gardens

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Pelham, NC
National Provider Identifier
1740517697
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PELHAM GARDENS
Doing business as
Pelham Gardens
Practice address
306 Old Hwy 29
Pelham, NC 27311
Phone
(336) 210-1446
NPI assigned
Nov 13, 2009
Last updated
Nov 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Mr. Gregory Vincent
Title
Owner/Ceo
Phone
(336) 210-1446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

306 Old Hwy 29
Pelham, NC 27311

Mailing address

PO Box 38551
Greensboro, NC 27438

Other names 1

  • Pelham Gardens Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pelham Gardens2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1740517697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38551",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 OLD HWY 29",
            "city": "PELHAM",
            "state": "NC",
            "postal_code": "27311",
            "telephone_number": "336-210-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM GARDENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "336-210-1446",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pelham Gardens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pelham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.