| Carolina Residential Services, Inc | |
|
1201 Wayne Memorial Dr Goldsboro NC 27534-2270 | |
| (919) 580-0020 | |
| (919) 580-0026 |
| Full Name | Carolina Residential Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1201 Wayne Memorial Dr, Goldsboro, North Carolina |
| Authorized Official Name and Position | Susan M Kincaid (DIRECTOR) |
| Authorized Official Contact | 8285722333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Residential Services, Inc Po Box 286 Rutherford College NC 28671-0286 Ph: (828) 572-2333 | Carolina Residential Services, Inc 1201 Wayne Memorial Dr Goldsboro NC 27534-2270 Ph: (919) 580-0020 |
| NPI Number | 1770626574 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 08/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770626574 | NPI | - | NPPES |
| 8301224S | Medicaid | NC | |
| 8303429S | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-096-005 (North Carolina) | Primary |
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