| Enfold Bh, Llc | |
|
555 Fayetteville St Ste Office50 Raleigh NC 27601-3030 | |
| (954) 254-6773 | |
| Not Available |
| Full Name | Enfold Bh, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 555 Fayetteville St Ste Office50, Raleigh, North Carolina |
| Authorized Official Name and Position | Sandra Zervoudakis (CLINICAL OPERATIONS) |
| Authorized Official Contact | 9542546773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enfold Bh, Llc Po Box 968 Cary NC 27512-0968 Ph: (954) 254-6773 | Enfold Bh, Llc 555 Fayetteville St Ste Office50 Raleigh NC 27601-3030 Ph: (954) 254-6773 |
| NPI Number | 1316567316 |
|---|---|
| Provider Enumeration Date | 04/20/2020 |
| Last Update Date | 07/01/2020 |
| Certification Date | 07/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316567316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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