| One Love Periodic Services | |
|
723 W Innes St Salisbury NC 28144-4149 | |
| (980) 330-7000 | |
| (704) 727-7450 |
| Full Name | One Love Periodic Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 723 W Innes St, Salisbury, North Carolina |
| Authorized Official Name and Position | Stevie Wideman (CEO) |
| Authorized Official Contact | 8284334567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| One Love Periodic Services 110 S Sterling St Morganton NC 28655-3483 Ph: (828) 433-4567 | One Love Periodic Services 723 W Innes St Salisbury NC 28144-4149 Ph: (980) 330-7000 |
| NPI Number | 1164791836 |
|---|---|
| Provider Enumeration Date | 12/23/2011 |
| Last Update Date | 10/04/2021 |
| Certification Date | 10/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164791836 | NPI | - | NPPES |
| 3410218 | Medicaid | NC | |
| 5916270 | Medicaid | NC | |
| 6008242 | Medicaid | NC | |
| 8301457H | Medicaid | NC | |
| 8301457V | Medicaid | NC | |
| 8703220 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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