Chaparral Youth Services II

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HC3855 Issued in NC

Legal business name

CHAPARRAL YOUTH SERVICES II

Practice address

68-B Three Hunts Drive
Pembroke, NC 28372

Phone

(910) 775-9076

Fax

(910) 775-9181

NPI assigned

Oct 17, 2014

Last updated

Mar 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sheree SampsonNPI 1912378993

Title

Ceo/Owner

Phone

(910) 827-1169

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Anglers Healthcare Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sheree L Sampson, LCMHC

  • Mental Health Counselor
  • Pembroke, NC
  • NPI 1912378993
  NPD (past) Authorized official

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584662400000",
    "number": "1881098093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68-B THREE HUNTS DRIVE",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "28372",
            "telephone_number": "910-775-9076",
            "fax_number": "910-775-9181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68-B THREE HUNTS DRIVE",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "28372",
            "telephone_number": "910-775-9076",
            "fax_number": "910-775-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAPARRAL YOUTH SERVICES II",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "SHEREE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "910-827-1169",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603911",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anglers Healthcare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mallory Carter, PT ASSISTANT
• Trisha Lynn Carter, LCSW
• Chaparral Youth Services
• Chaparral Youth Services II
• Chaparral Youth Services II
• Andrea L Chappell, PHARMD
• Angel Marie Chavis
• Brooke Leanne Chavis, PHARMD
• Katara S Chavis, FNP-C
• Marcia Reanee Chavis, MBA, MA, LCASA

• Home Health Agency in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.