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15354 Sam Potts Hwy Bolton NC 28423-8408 | |
(919) 460-8522 | |
(919) 460-8502 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 15354 Sam Potts Hwy, Bolton, North Carolina |
Authorized Official Name and Position | Sharita M. Lawson (PRINCIPAL) |
Authorized Official Contact | 9194608522 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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659 Cary Towne Blvd #203 Cary NC 27511-4219 Ph: (919) 460-8522 | 15354 Sam Potts Hwy Bolton NC 28423-8408 Ph: (919) 460-8522 |
NPI Number | 1891920039 |
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Provider Enumeration Date | 05/18/2009 |
Last Update Date | 05/18/2009 |
Identifier | Type | State | Issuer |
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1891920039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | MHL024078 (North Carolina) | Primary |