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3972 Business 17 E Ste C Bolivia NC 28422-9030 | |
| (910) 253-8700 | |
| (910) 253-8755 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3972 Business 17 E, Bolivia, North Carolina |
| Authorized Official Name and Position | Harold Ernest Jones (MEMBER) |
| Authorized Official Contact | 9192560824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3210 Fairhill Dr Raleigh NC 27612-3215 Ph: (919) 256-0824 | 3972 Business 17 E Ste C Bolivia NC 28422-9030 Ph: (910) 253-8700 |
| NPI Number | 1396010047 |
|---|---|
| Provider Enumeration Date | 03/14/2012 |
| Last Update Date | 05/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396010047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Community Innovations, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3972 Business 17 E, Ste C, Bolivia, NC 28422 Phone: 910-253-8700 Fax: 910-253-8755 | |
Community Innovations, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3972 Business 17 E, Ste C, Bolivia, NC 28422 Phone: 910-253-8700 Fax: 910-253-8755 | |
Coastal Horizons Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4036 Business 17 E Bldg 6004036, Bolivia, NC 28422 Phone: 910-703-8800 Fax: 910-754-7997 |