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100 Hospital Dr Louisburg NC 27549-2256 | |
| (919) 496-5131 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 100 Hospital Dr, Louisburg, North Carolina |
| Authorized Official Name and Position | Jody Morris (PRESIDENT/COO) |
| Authorized Official Contact | 9194978401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2085 Frontis Plaza Blvd Winston Salem NC 27103-5614 Ph: (919) 496-5131 | 100 Hospital Dr Louisburg NC 27549-2256 Ph: (919) 496-5131 |
| NPI Number | 1366796815 |
|---|---|
| Provider Enumeration Date | 11/06/2012 |
| Last Update Date | 07/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366796815 | NPI | - | NPPES |
| 3400036 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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