NPIMap

Organization Active NPI

Residential Support Services of Wake County, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Raleigh, NC
National Provider Identifier
1922430172
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
MHL-092-473 Issued in NC
Legal business name
RESIDENTIAL SUPPORT SERVICES OF WAKE COUNTY, INC.
Practice address
408 Hailey Dr
Raleigh, NC 27606-2429
Phone
(919) 787-1214
Fax
(919) 787-3416
NPI assigned
Jul 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Authorized official

Name
Susan Murray
Title
Executive Assistant
Phone
(919) 787-1214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-092-473 NC Primary

Addresses

Primary practice location

408 Hailey Dr
Raleigh, NC 27606-2429

Mailing address

PO Box 98476
Raleigh, NC 27624-8476
Phone (919) 787-1214

Other identifiers 7

IdentifierTypeStateIssuer
8300856BMedicaidNC
7804508MedicaidNC
3418153MedicaidNC
7804509MedicaidNC
7804510MedicaidNC
8300856MedicaidNC
8702203MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Residential Support Services of Wake County Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1922430172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98476",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276248476",
            "telephone_number": "919-787-1214",
            "fax_number": "919-787-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 HAILEY DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276062429",
            "telephone_number": "919-787-1214",
            "fax_number": "919-787-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL SUPPORT SERVICES OF WAKE COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "919-787-1214"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-092-473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300856B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804508",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418153",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804509",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804510",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300856",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8702203",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.