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1101 S Fifth St Mebane NC 27302-9182 | |
| (336) 380-0772 | |
| (336) 270-6303 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1101 S Fifth St, Mebane, North Carolina |
| Authorized Official Name and Position | Lorenzo Moore (MANAGING EMPLOYEE) |
| Authorized Official Contact | 3363800772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 5144 Burlington NC 27216-5144 Ph: (336) 380-0772 | 1101 S Fifth St Mebane NC 27302-9182 Ph: (336) 380-0772 |
| NPI Number | 1538309182 |
|---|---|
| Provider Enumeration Date | 02/23/2009 |
| Last Update Date | 02/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538309182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3747P1801X (North Carolina) | Primary |
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