NPIMap

Organization Active NPI

Vision Youth Group Home,Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Greensboro, NC
National Provider Identifier
1962564658
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
MHL-041-142 Issued in NC
Legal business name
VISION YOUTH GROUP HOME,INC.
Practice address
605 Thornberry Dr
Greensboro, NC 27455-1517
Phone
(336) 282-5060
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Jimmy Guess, MSW,LCSW
Title
Executive Director
Phone
(336) 508-2203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-041-142 NC Primary

Addresses

Primary practice location

605 Thornberry Dr
Greensboro, NC 27455-1517

Mailing address

6107 Bascom Dr
Summerfield, NC 27358-9119
Phone (336) 508-2203

Other identifiers 1

IdentifierTypeStateIssuer
6603098MedicaidNC

Other names 1

  • Thornberry Place Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Banoyd Place3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1962564658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 BASCOM DR",
            "city": "SUMMERFIELD",
            "state": "NC",
            "postal_code": "273589119",
            "telephone_number": "336-508-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 THORNBERRY DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274551517",
            "telephone_number": "336-282-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION YOUTH GROUP HOME,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "GUESS",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-508-2203",
        "authorized_official_credential": "MSW,LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-041-142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603098",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thornberry Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.