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400 Peacock St Ahoskie NC 27910-3930 | |
| (800) 866-0860 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 400 Peacock St, Ahoskie, North Carolina |
| Authorized Official Name and Position | Deena Ombres (PRIVACY OFFICER) |
| Authorized Official Contact | 5023942387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9901 Linn Station Rd Louisville KY 40223-3808 Ph: (800) 866-0860 | 400 Peacock St Ahoskie NC 27910-3930 Ph: (800) 866-0860 |
| NPI Number | 1043454432 |
|---|---|
| Provider Enumeration Date | 04/29/2009 |
| Last Update Date | 04/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043454432 | NPI | - | NPPES |
| 6601782 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
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