Alpha Delta Family Services Group, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-068-111 Issued in NC

Legal business name

ALPHA DELTA FAMILY SERVICES GROUP, INC.

Practice address

7612 N NC Highway 49
Mebane, NC 27302-7519

Phone

(336) 562-5300

Fax

(336) 562-5500

NPI assigned

Jan 30, 2007

Last updated

Aug 22, 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. Trina D Torain

Title

Qualified Professional

Phone

(336) 562-5300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jacobs Tree House Other name

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982740205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7612 N NC HIGHWAY 49",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273027519",
            "telephone_number": "336-562-5300",
            "fax_number": "336-562-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7612 N NC HIGHWAY 49",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273027519",
            "telephone_number": "336-562-5300",
            "fax_number": "336-562-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA DELTA FAMILY SERVICES GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TORAIN",
        "authorized_official_first_name": "TRINA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "QUALIFIED PROFESSIONAL",
        "authorized_official_telephone_number": "336-562-5300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-068-111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603634",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacobs Tree House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Mebane, NC
• Providers in Mebane, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.