Full Name | |
---|---|
Speciality | Clinic/center - Adult Mental Health |
Location | 76 Louise St, Gates, North Carolina |
Authorized Official Name and Position | Rondeshya K Cosby (OWNER) |
Authorized Official Contact | 2523705222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2977 Elizabeth City NC 27906-2977 Ph: (252) 370-5222 | 76 Louise St Gates NC 27937-9834 Ph: (252) 370-5222 |
NPI Number | 1316676380 |
---|---|
Provider Enumeration Date | 06/06/2022 |
Last Update Date | 06/20/2022 |
Certification Date | 06/20/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316676380 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Secondary |
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |