| |
157 Dublin Square Rd Ste P Asheboro NC 27203-8691 | |
(336) 626-9091 | |
(336) 625-3720 |
Full Name | |
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Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 157 Dublin Square Rd Ste P, Asheboro, North Carolina |
Authorized Official Name and Position | Ted Fitzgerald (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9108917062 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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108 N Orange Ave Dunn NC 28334-3826 Ph: (910) 891-7062 | 157 Dublin Square Rd Ste P Asheboro NC 27203-8691 Ph: (336) 626-9091 |
NPI Number | 1740486463 |
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Provider Enumeration Date | 06/21/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740486463 | NPI | - | NPPES |
8301418Q | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | MHL-076-082 (North Carolina) | Primary |
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