Community Advancement Agency LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMUNITY ADVANCEMENT AGENCY LLC

Practice address

2020 Remount Rd Ste W-107
Gastonia, NC 28054-7476

Phone

(704) 594-4633

NPI assigned

Jan 9, 2017

Organization subpart

No

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

Authorized official

Name

Julian Tingle

Title

Executive Director

Phone

(704) 594-4717

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651622400000",
    "number": "1992241335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 REMOUNT RD STE W-107",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547476",
            "telephone_number": "704-594-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 REMOUNT RD STE W-107",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547476",
            "telephone_number": "704-594-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ADVANCEMENT AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-09",
        "last_updated": "2022-05-04",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "TINGLE",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-594-4717"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "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 May 4, 2022; 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.