NPIMap

Organization Active NPI

Southlight Healthcare

  • Community/Behavioral Health Agency
  • Garner, NC
National Provider Identifier
1851597801
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHL092461 Issued in NC
Legal business name
SOUTHLIGHT HEALTHCARE
Practice address
1952 Spring Dr
Garner, NC 27529-3486
Phone
(919) 557-6967
Fax
(919) 557-6871
NPI assigned
Jun 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Adam Hartzell
Title
Ceo
Phone
(919) 787-6131

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X MHL092461 NC Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Multi-Specialty Clinic/Center 261QM1300X
Methadone Clinic 261QM2800X

Addresses

Primary practice location

1952 Spring Dr
Garner, NC 27529-3486

Mailing address

3125 Poplarwood Court
Suite 203
Raleigh, NC 27604-6445
Phone (919) 787-6131

Other identifiers 1

IdentifierTypeStateIssuer
8300978MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Southlight Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1952 Spring Dr
Garner, NC 27529
Phone (919) 557-6967

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1851597801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD COURT",
            "address_2": "SUITE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 SPRING DR",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293486",
            "telephone_number": "919-557-6967",
            "fax_number": "919-557-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLIGHT HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2022-12-13",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "HARTZELL",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-787-6131"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL092461",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300978",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.