| Rehoboth Consulting Agency | |
|
2501 Poole Rd Raleigh NC 27610-2819 | |
| (919) 834-2604 | |
| (919) 834-2607 |
| Full Name | Rehoboth Consulting Agency |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2501 Poole Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Lisa L. King (FOUNDER/PRESIDENT) |
| Authorized Official Contact | 9192313352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rehoboth Consulting Agency Po Box 14449 Raleigh NC 27620-4449 Ph: (919) 834-2604 | Rehoboth Consulting Agency 2501 Poole Rd Raleigh NC 27610-2819 Ph: (919) 834-2604 |
| NPI Number | 1184816555 |
|---|---|
| Provider Enumeration Date | 08/09/2007 |
| Last Update Date | 10/19/2011 |
| Medicare PECOS PAC ID | 6901059690 |
|---|---|
| Medicare Enrollment ID | O20130107000195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184816555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Eric Mizelle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780737072 PECOS PAC ID: 4486619103 Enrollment ID: I20130122000339 |
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