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106 Vance St E Wilson NC 27893-4034 | |
| (919) 744-4461 | |
| (919) 550-1921 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 106 Vance St E, Wilson, North Carolina |
| Authorized Official Name and Position | Lora S Williams (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9197444461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1775 Clayton NC 27528-1775 Ph: (919) 744-4461 | 106 Vance St E Wilson NC 27893-4034 Ph: (919) 744-4461 |
| NPI Number | 1801233713 |
|---|---|
| Provider Enumeration Date | 05/31/2013 |
| Last Update Date | 05/31/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801233713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C008251 (North Carolina) | Primary |
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