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4344 S Nc Highway 150 Ste D Lexington NC 27295 | |
| (336) 880-1855 | |
| (336) 553-9175 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4344 S Nc Highway 150 Ste D, Lexington, North Carolina |
| Authorized Official Name and Position | Celeste Inez Dominguez (PRESIDENT/CEO) |
| Authorized Official Contact | 7048732211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
194 Barium Springs Dr Statesville NC 28677-8453 Ph: (048) 322-2007 | 4344 S Nc Highway 150 Ste D Lexington NC 27295 Ph: (336) 880-1855 |
| NPI Number | 1093136335 |
|---|---|
| Provider Enumeration Date | 01/03/2014 |
| Last Update Date | 02/08/2023 |
| Certification Date | 02/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093136335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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