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309 Westonridge Run Garner NC 27529-5327 | |
| (919) 395-4698 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 309 Westonridge Run, Garner, North Carolina |
| Authorized Official Name and Position | Deena G. Ombres (ASSOC. GEN. COUNSEL/PRIVACY OFFICER) |
| Authorized Official Contact | 5023942100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9901 Linn Station Rd Louisville KY 40223-3808 Ph: (502) 394-2100 | 309 Westonridge Run Garner NC 27529-5327 Ph: (919) 395-4698 |
| NPI Number | 1225461460 |
|---|---|
| Provider Enumeration Date | 08/12/2013 |
| Last Update Date | 08/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225461460 | NPI | - | NPPES |
| 3408589 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
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