| N/a | |
|
2555 Capitol Dr Ste E-2 Creedmoor NC 27522-7398 | |
| (919) 931-8838 | |
| Not Available |
| Full Name | N/a |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2555 Capitol Dr Ste E-2, Creedmoor, North Carolina |
| Authorized Official Name and Position | Fredricka Breaker (CEO) |
| Authorized Official Contact | 9199318838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| N/a 2555 Capitol Dr Ste E-2 Creedmoor NC 27522-7398 Ph: (757) 406-9040 | N/a 2555 Capitol Dr Ste E-2 Creedmoor NC 27522-7398 Ph: (919) 931-8838 |
| NPI Number | 1386409894 |
|---|---|
| Provider Enumeration Date | 02/14/2024 |
| Last Update Date | 09/24/2024 |
| Certification Date | 09/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386409894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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