| Mybrotherskeeper | |
|
816 Paul St Rocky Mount NC 27803-3337 | |
| (252) 985-2735 | |
| (252) 985-1952 |
| Full Name | Mybrotherskeeper |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 816 Paul St, Rocky Mount, North Carolina |
| Authorized Official Name and Position | Barbara Jean Wilson (ADMINISTRATOR) |
| Authorized Official Contact | 2529852735 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mybrotherskeeper 816 Paul St Rocky Mount NC 27803-3337 Ph: (252) 985-2735 | Mybrotherskeeper 816 Paul St Rocky Mount NC 27803-3337 Ph: (252) 985-2735 |
| NPI Number | 1184748238 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 07/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184748238 | NPI | - | NPPES |
| 7804401 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | MHL064060 (North Carolina) | Primary |
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