WORD OF LIFE OUTREACH OF CAPE FEAR, INC. NPI 1003042904

Community/Behavioral Health in Leland, NC

NPI 1003042904 Organization Community/Behavioral Health

About WORD OF LIFE OUTREACH OF CAPE FEAR, INC.

Word Of Life Outreach Of Cape Fear, Inc. is a provider established in Leland, North Carolina specializing in community/behavioral health. The NPI number of Word Of Life Outreach Of Cape Fear, Inc. is 1003042904 and was assigned on June 2009. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Mr. Jeffery A Johnson Ba (Ceo)

NPI

1003042904

Provider NameWORD OF LIFE OUTREACH OF CAPE FEAR, INC.
Provider Location Address10225 BLACKWELL RD SE LELAND, NC 28451
Provider Mailing AddressPO BOX 717 LELAND, NC 28451
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date06-05-2009
Last Update Date06-05-2009


Primary Taxonomy

Taxonomy Code251S00000X
ClassificationCommunity/Behavioral Health
TypeAgencies
Taxonomy DescriptionA 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.

Business Address

WORD OF LIFE OUTREACH OF CAPE FEAR, INC.
10225 BLACKWELL RD SE
LELAND, NC
ZIP 28451
Phone: (910) 371-5300
Fax: (910) 371-5302

Get Directions


Mailing Address

WORD OF LIFE OUTREACH OF CAPE FEAR, INC.
PO BOX 717
LELAND, NC
ZIP 28451
Phone: (910) 371-5300
Fax: (910) 371-5302



Authorized Official

Authorized Official NameMR. JEFFERY A JOHNSON BA
Authorized Official TitleCEO
Authorized Official Phone(910) 547-8792

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
8301346HMEDICAID (05)NC

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104961861WORD OF LIFE OUTREACH OF CAPE FEAR INC
Organization
Counselor (Mental Health)10225 BLACKWELL RD SE
LELAND, NC 28451
(910) 371-5300
1184928152WORD OF LIFE OUTREACH OF CAPE FEAR, INC
Organization
Community/Behavioral Health10225 BLACKWELL RD SE
LELAND, NC 28451
(910) 233-7550

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.