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217 Morven Rd Wadesboro NC 28170-2738 | |
(704) 694-2610 | |
(704) 694-2616 |
Full Name | |
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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 |
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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 |
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Provider Enumeration Date | 05/02/2008 |
Last Update Date | 04/02/2009 |
Identifier | Type | State | Issuer |
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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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