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217 Morven Rd Wadesboro NC 28170-2738 | |
| (704) 694-2610 | |
| (704) 694-2616 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 217 Morven Rd, Wadesboro, North Carolina |
| Authorized Official Name and Position | Lawrence O. Elliott (CEO/DIRECTOR) |
| Authorized Official Contact | 7046942610 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 124 Wadesboro NC 28170-0124 Ph: (704) 694-2610 | 217 Morven Rd Wadesboro NC 28170-2738 Ph: (704) 694-2610 |
| NPI Number | 1679749386 |
|---|---|
| Provider Enumeration Date | 05/02/2008 |
| Last Update Date | 04/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679749386 | NPI | - | NPPES |
| 6006180 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5580 (North Carolina) | Primary |
| 101YP2500X | Counselor - Professional | 6749 (North Carolina) | Secondary |
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