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1709 Centre St W Wilson NC 27893-2781 | |
| (919) 737-4895 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1709 Centre St W, Wilson, North Carolina |
| Authorized Official Name and Position | Keane Q Sauls (OWNER) |
| Authorized Official Contact | 9197374895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1709 Centre St W Wilson NC 27893-2781 Ph: (919) 737-4895 | 1709 Centre St W Wilson NC 27893-2781 Ph: (919) 737-4895 |
| NPI Number | 1508549700 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508549700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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