Community Transformation Foundation LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMUNITY TRANSFORMATION FOUNDATION LLC

Practice address

1200 E Morehead St
Suite 100
Charlotte, NC 28204-2850

Phone

(704) 905-6866

NPI assigned

Jul 31, 2011

Last updated

Jul 31, 2011By 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

Mr. Ervin Dexter Blakney II

Title

Owner

Phone

(704) 712-1816

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1312070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312070400000",
    "number": "1912285529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MOREHEAD ST",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042850",
            "telephone_number": "704-905-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MOREHEAD ST",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042850",
            "telephone_number": "704-905-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY TRANSFORMATION FOUNDATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-31",
        "last_updated": "2011-07-31",
        "status": "A",
        "authorized_official_last_name": "BLAKNEY",
        "authorized_official_first_name": "ERVIN",
        "authorized_official_middle_name": "DEXTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-712-1816",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2011; 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.