| Club Nova Community Inc | |
|
103 W Main St Ste D Carrboro NC 27510-1691 | |
| (919) 968-6682 | |
| (919) 968-2522 |
| Full Name | Club Nova Community Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 103 W Main St Ste D, Carrboro, North Carolina |
| Authorized Official Name and Position | Karen Kinkaid Dunn (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9199686682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Club Nova Community Inc Po Box 1346 Carrboro NC 27510-3346 Ph: (919) 968-6682 | Club Nova Community Inc 103 W Main St Ste D Carrboro NC 27510-1691 Ph: (919) 968-6682 |
| NPI Number | 1477784627 |
|---|---|
| Provider Enumeration Date | 08/06/2009 |
| Last Update Date | 08/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477784627 | NPI | - | NPPES |
| 8301156-S | Medicaid | NC | |
| 8301156-B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C005810 (North Carolina) | Primary |
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