| Port City Academy | |
|
20 N 4th St Suite 300b Wilmington NC 28401-4553 | |
| (704) 982-9600 | |
| (704) 982-8155 |
| Full Name | Port City Academy |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 20 N 4th St, Wilmington, North Carolina |
| Authorized Official Name and Position | Dawn Harwood Allen (CEO) |
| Authorized Official Contact | 7049829600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port City Academy Po Box 2487 Albemarle NC 28002-2487 Ph: (704) 982-9600 | Port City Academy 20 N 4th St Suite 300b Wilmington NC 28401-4553 Ph: (704) 982-9600 |
| NPI Number | 1962836460 |
|---|---|
| Provider Enumeration Date | 09/03/2013 |
| Last Update Date | 09/28/2020 |
| Certification Date | 09/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962836460 | NPI | - | NPPES |
| 3408844 | Medicaid | NC |
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