NPIMap

Organization Active NPI

Specialized Children's Care, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Greensboro, NC
National Provider Identifier
1760490577
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL-097-054 Issued in NC
Legal business name
SPECIALIZED CHILDREN'S CARE, INC.
Practice address
430 Battleground Ave
Greensboro, NC 27401-2104
Phone
(336) 574-0981
Fax
(336) 574-0982
NPI assigned
Aug 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kenneth Bernard Whitmire, QMHP
Title
Executive Director
Phone
(336) 574-0981

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-077-039 NC
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-041-601 NC
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-097-054 NC Primary

Addresses

Primary practice location

430 Battleground Ave
Greensboro, NC 27401-2104

Mailing address

430 Battleground Ave
Greensboro, NC 27401-2104
Phone (336) 574-0981

Other identifiers 3

IdentifierTypeStateIssuer
6603163MedicaidNC
6603644MedicaidNC
6603164MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760490577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BATTLEGROUND AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012104",
            "telephone_number": "336-574-0981",
            "fax_number": "336-574-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BATTLEGROUND AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274012104",
            "telephone_number": "336-574-0981",
            "fax_number": "336-574-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED CHILDREN'S CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITMIRE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-574-0981",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "QMHP"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-077-039",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-041-601",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-097-054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603163",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603644",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603164",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.