Active NPI
Intensive Mental Care Inc
- Community/Behavioral Health Agency
- Charlotte, NC
National Provider Identifier
1962712653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- INTENSIVE MENTAL CARE INC
- Practice address
- 2015 Ayrsley Town Blvd Ste 202
Charlotte, NC 28273-4068 - Phone
- (252) 312-8207
- Fax
- (888) 535-2496
- NPI assigned
- Oct 14, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eulanda Elliott
- Title
- President
- Phone
- (252) 312-8207
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Psychiatry Physician | 2084P0800X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
2015 Ayrsley Town Blvd Ste 202
Charlotte, NC 28273-4068
Mailing address
PO Box 1207
Wake Forest, NC 27588-1207
Phone (252) 312-8207
Other names 1
- Intensive Rehab Health Services
National Provider Directory
National Provider Directory- Tax ID family
- Intensive Mental Care Inc
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Hertford, NC
- NPI 1174755938
-
- Clinical Social Worker
- Charlotte, NC
- NPI 1285944801
-
- Community/Behavioral Health Agency
- Elizabeth City, NC
- NPI 1427338565
-
- Community/Behavioral Health Agency
- Gatesville, NC
- NPI 1679705958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1287014400000",
"number": "1962712653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1207",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275881207",
"telephone_number": "252-312-8207",
"fax_number": "888-535-2496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 AYRSLEY TOWN BLVD STE 202",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282734068",
"telephone_number": "252-312-8207",
"fax_number": "888-535-2496"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTENSIVE MENTAL CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-14",
"last_updated": "2010-10-14",
"status": "A",
"authorized_official_last_name": "ELLIOTT",
"authorized_official_first_name": "EULANDA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "252-312-8207"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Intensive Rehab Health Services",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.