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GREATER IMAGE HEALTHCARE CORP NPI 1255574034


NPI Information

NPI: 1255574034
Provider Name: GREATER IMAGE HEALTHCARE, CORP
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
401 ROBERSON STREET
FAYETTEVILLE, NC
ZIP 28301
Phone: (910) 321-0069
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GREATER IMAGE HEALTHCARE, CORP is a community behavioral health in Fayetteville, NC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. GREATER IMAGE HEALTHCARE, CORP NPI is 1255574034. The provider is registered as an organization entity type.

The provider's business location address is:

401 ROBERSON STREET
FAYETTEVILLE, NC
ZIP 28301-423
Phone: (910) 321-0069
Fax: (910) 491-1000

The provider's authorized official is Rodney Johnson .
The authorized official title is Ceo and has the following contact phone number (910) 321-0069.

The enumeration date for this NPI number is 4/9/2009 and was last updated on 7/15/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesNo
2251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11508996059MEDICAIDNORTH CAROLINA
26008694MEDICAIDNORTH CAROLINA
35919267MEDICAIDNORTH CAROLINA
48302847MEDICAIDNORTH CAROLINA
51457481988MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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