| Ingram Health Services/manna House,inc | |
|
505 West Martin Luther King Drive Maxton NC 28364 | |
| (910) 844-6262 | |
| (910) 844-6265 |
| Full Name | Ingram Health Services/manna House,inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 505 West Martin Luther King Drive, Maxton, North Carolina |
| Authorized Official Name and Position | Deborah Faye Ingram (CEO) |
| Authorized Official Contact | 9103183946 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingram Health Services/manna House,inc 675 Nc Hwy 71 N Maxton NC 28364 Ph: (910) 844-6262 | Ingram Health Services/manna House,inc 505 West Martin Luther King Drive Maxton NC 28364 Ph: (910) 844-6262 |
| NPI Number | 1871722637 |
|---|---|
| Provider Enumeration Date | 07/14/2009 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871722637 | NPI | - | NPPES |
| 8301873 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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