NPIMap

Organization Active NPI

Towergate Youth and Family Services

  • Mental Illness Community Based Residential Treatment Facility
  • Winston Salem, NC
National Provider Identifier
1770617474
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-060-822 Issued in NC
Legal business name
TOWERGATE YOUTH AND FAMILY SERVICES
Practice address
500 W 4TH St
Suite 203
Winston Salem, NC 27101-2782
Phone
(704) 701-2123
NPI assigned
Mar 15, 2007
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
Brad Lessane
Title
VP Finance
Phone
(704) 701-2123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-060-822 NC Primary

Addresses

Primary practice location

500 W 4TH St
Suite 203
Winston Salem, NC 27101-2782

Mailing address

PO Box 822
Concord, NC 28026-0822

Other identifiers 1

IdentifierTypeStateIssuer
8301759MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Towergate Youth and Family Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 W 4th St
Ste 203
Winston Salem, NC 27101
Phone (336) 391-1601

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770617474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 822",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280260822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "address_2": "SUITE 203",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012782",
            "telephone_number": "704-701-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWERGATE YOUTH AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LESSANE",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "704-701-2123"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-060-822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301759",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, 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.