| Shadows Community Support Center | |
|
7356 Us Highway 64 Robersonville NC 27871-9073 | |
| (252) 795-6662 | |
| (252) 795-6696 |
| Full Name | Shadows Community Support Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 7356 Us Highway 64, Robersonville, North Carolina |
| Authorized Official Name and Position | Gloria Crandell-nelson (CEO) |
| Authorized Official Contact | 2527956662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shadows Community Support Center 7356 Hwy 64 E Robersonville NC 27871-0278 Ph: (252) 795-6662 | Shadows Community Support Center 7356 Us Highway 64 Robersonville NC 27871-9073 Ph: (252) 795-6662 |
| NPI Number | 1700909454 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 07/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700909454 | NPI | - | NPPES |
| 6006991 | Medicaid | NC | |
| 5950083 | Medicaid | NC | |
| 8301939 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (North Carolina) | Primary |
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Gloria Crandell-nelson Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7356 Hwy 64 E Alt, Robersonville, NC 27871 Phone: 252-795-6662 | |
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Peace Of Mind Human Service, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 West Acdemy Street, 107 West Acedemy Street, Robersonville, NC 27871 Phone: 252-795-4267 Fax: 252-795-4267 | |
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