Carolina Choice Llc | |
5353 Red Tip Rd Suite 111 Fayetteville NC 28314-1567 | |
(910) 485-0330 | |
(910) 482-0330 |
Full Name | Carolina Choice Llc |
---|---|
Speciality | Counselor - Mental Health |
Location | 5353 Red Tip Rd, Fayetteville, North Carolina |
Authorized Official Name and Position | Donna Simon (BILLING OFFICER) |
Authorized Official Contact | 2526333855 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Carolina Choice Llc Po Box 12189 New Bern NC 28561-2189 Ph: (252) 633-3855 | Carolina Choice Llc 5353 Red Tip Rd Suite 111 Fayetteville NC 28314-1567 Ph: (910) 485-0330 |
NPI Number | 1215063276 |
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Provider Enumeration Date | 02/26/2007 |
Last Update Date | 09/17/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215063276 | NPI | - | NPPES |
8301024 | Medicaid | NC | |
8301024B | Medicaid | NC | |
8301024H | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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