The Professional Group, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL026825 Issued in NC

Legal business name

THE PROFESSIONAL GROUP, INC.

Practice address

2665 Rivercliff Rd
Fayetteville, NC 28301-3874

Phone

(910) 826-9800

Fax

(910) 483-4004

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Erwin Kelly

Title

Exective Director

Phone

(910) 483-2002

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821173147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35723",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283030723",
            "telephone_number": "910-483-2002",
            "fax_number": "910-483-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 RIVERCLIFF RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013874",
            "telephone_number": "910-826-9800",
            "fax_number": "910-483-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PROFESSIONAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ERWIN",
        "authorized_official_title_or_position": "EXECTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-483-2002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL026825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• 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.