| Atlas At Trinity | |
|
10241 Blackwell Rd Se Leland NC 28451-8515 | |
| (910) 371-5300 | |
| (910) 371-5302 |
| Full Name | Atlas At Trinity |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10241 Blackwell Rd Se, Leland, North Carolina |
| Authorized Official Name and Position | Jeffery Johnson (ADMINISTRATOR) |
| Authorized Official Contact | 9103715300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlas At Trinity Po Box 717 Leland NC 28451-0717 Ph: (910) 371-5300 | Atlas At Trinity 10241 Blackwell Rd Se Leland NC 28451-8515 Ph: (910) 371-5300 |
| NPI Number | 1912141219 |
|---|---|
| Provider Enumeration Date | 04/30/2009 |
| Last Update Date | 04/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912141219 | NPI | - | NPPES |
| 8302371R | Medicaid | NC | |
| 8301346G | Medicaid | NC | |
| 8302371S | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL 010-061 (North Carolina) | Primary |
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