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110 E Boston Ave Pinebluff NC 28373-8033 | |
(910) 281-5327 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 110 E Boston Ave, Pinebluff, North Carolina |
Authorized Official Name and Position | Kevin Cochran (FINANCIAL ASSISTANT) |
Authorized Official Contact | 9199810740 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1331 Sunday Dr Raleigh NC 27607 Ph: (919) 981-0740 | 110 E Boston Ave Pinebluff NC 28373-8033 Ph: (910) 281-5327 |
NPI Number | 1417080441 |
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Provider Enumeration Date | 03/13/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1417080441 | NPI | - | NPPES |
8300426S | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | MHL-063-009 (North Carolina) | Primary |