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SOUTHLIGHT HEALTHCARE NPI 1962556803


NPI Information

NPI: 1962556803
Provider Name: SOUTHLIGHT HEALTHCARE

Other Name: PATHWAYS

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 34D2114112

Address:
2101 GARNER RD
RALEIGH, NC
ZIP 27610
Phone: (919) 787-6131
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SOUTHLIGHT HEALTHCARE is a community behavioral health in Raleigh, 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. SOUTHLIGHT HEALTHCARE NPI is 1962556803. The provider is registered as an organization entity type.
The provider Other Name Is Pathways.

The provider's business location address is:

2101 GARNER RD
RALEIGH, NC
ZIP 27610-114
Phone: (919) 787-6131
Fax: (919) 571-2932

The provider's authorized official is Adam Hartzell .
The authorized official title is Ceo and has the following contact phone number (919) 787-6131.

The CLIA number assigned to this NPI record is 34D2114112 - other - residential trtmt prog with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 12/13/2022.


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
1251B00000XCase ManagementNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
3261QM0850XClinic/CenterAdult Mental HealthNo
4261QM1300XClinic/CenterMulti-SpecialtyNo
5261QM2800XClinic/CenterMethadoneNo
6251S00000XCommunity/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
15901811MEDICAIDNORTH CAROLINA
28300533OTHERMULT SPECIALTY ANNOUNCE
307197OTHERNORTH CAROLINABCBS
46005404OTHERNORTH CAROLINAMCAID

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.