NPIMap

Organization Active NPI

Pine Village Treatment Services, Inc.

  • Community/Behavioral Health Agency
  • Clayton, NC
National Provider Identifier
1760657282
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PINE VILLAGE TREATMENT SERVICES, INC.
Practice address
106 S Lombard St
Clayton, NC 27520-2527
Phone
(919) 550-7645
NPI assigned
Apr 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Mr. James D Garrett
Title
President
Phone
(910) 354-4794

Specialties & licenses 1

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

Addresses

Primary practice location

106 S Lombard St
Clayton, NC 27520-2527

Mailing address

106 S Lombard St
Clayton, NC 27520-2527
Phone (919) 550-7645

Other identifiers 1

IdentifierTypeStateIssuer
8302128MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pine Village Treatment Services 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.

Locations

106 S Lombard St
Clayton, NC 27520
Phone (919) 550-7645

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1760657282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S LOMBARD ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202527",
            "telephone_number": "919-550-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S LOMBARD ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202527",
            "telephone_number": "919-550-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE VILLAGE TREATMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-354-4794",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302128",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.