Spirit Of Excellence Community Outreach,inc.
Psychiatric Residential Treatment Facility in Jacksonville, North Carolina
NPI 1942333240
Spirit Of Excellence Community Outreach,inc. is a Psychiatric Residential Treatment Facility based in Jacksonville, NC. Spirit Of Excellence Community Outreach,inc. practices in Jacksonville, NC. The NPI Number for Spirit Of Excellence Community Outreach,inc. is 1942333240 and holds a License No. (North Carolina).
The current practice location address for Spirit Of Excellence Community Outreach,inc. is 123 Henderson Dr, Jacksonville, NC and can be reached out via phone at 910-939-4663 and via fax at 910-939-5079.
Location: 123 Henderson Dr, Jacksonville, NC, 28541-0752
Provider Profile Details
NPI Number
1942333240
Provider Name
Spirit Of Excellence Community Outreach,inc.
Credential
Provider Entity Type
Organization
Address
123 Henderson Dr, Jacksonville, NC, 28541-0752
Phone Number
910-939-4663
Fax Number
910-939-5079
Provider Enumeration Date
03/14/2007
Last Update Date
03/12/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3418119 | 05 | NC | |
| 8301352 | 05 | NC | |
| 8301352G | 05 | NC | |
| 3408311 | 05 | NC | |
| 6602173 | 05 | NC | |
| 001GM | 01 | NC | BLUE CROSS BLUE SHIELD |
| 009EJ | 01 | NC | BLUE CROSS BLUE SHIELD |
| 6006360 | 05 | NC | |
| 7805061 | 05 | NC | |
| 6601227 | 05 | NC | |
| 8301352B | 05 | NC |
Provider Business Practice Location Address Details
Address
123 Henderson Dr
City
State
Zip
28540-5601
Phone Number
910-939-4663
Fax Number
910-939-5079
Provider Business Mailing Address Details
Address
123 Henderson Dr
City
State
Zip
28540-5601
Phone Number
910-939-4663
Fax Number
910-939-5079
Provider's Taxonomy Details 1
Type
Agencies
Classification
Case Management
Speciality
-
Taxonomy
License No.
MHL-067-164 (North Carolina)
Definition
An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
Provider's Taxonomy Details 2
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
License No.
()
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Provider's Taxonomy Details 3
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
License No.
()
Definition
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.
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Provider's Taxonomy Details 6
Type
Nursing & Custodial Care Facilities
Classification
Custodial Care Facility
Speciality
Adult Care Home
Taxonomy
License No.
()
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Provider's Taxonomy Details 7
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Provider's Taxonomy Details 8
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Provider's Taxonomy Details 9
Type
Residential Treatment Facilities
Classification
Psychiatric Residential Treatment Facility
Speciality
-
Taxonomy
License No.
()
Definition
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
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