Full Name | |
---|---|
Speciality | Counselor - Professional |
Location | 34 W Main St, Hamlet, North Carolina |
Authorized Official Name and Position | Shirley W. Liles (CORPORATE COMPLIANCE OFFICER) |
Authorized Official Contact | 7046952391 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
34 W Main St Hamlet NC 28345-3636 Ph: (170) 447-5644 | 34 W Main St Hamlet NC 28345-3636 Ph: (170) 447-5644 |
NPI Number | 1770075368 |
---|---|
Provider Enumeration Date | 05/31/2018 |
Last Update Date | 05/31/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770075368 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | MHL-077-081 (North Carolina) | Primary |
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