| Walter B. Jones Woodside Treatment Center Otp | |
|
2577 W 5th St Greenville NC 27834-7813 | |
| (252) 707-5208 | |
| (252) 707-5267 |
| Full Name | Walter B. Jones Woodside Treatment Center Otp |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2577 W 5th St, Greenville, North Carolina |
| Authorized Official Name and Position | Beoncia Brown (COMPLIANCE COORDINATOR) |
| Authorized Official Contact | 9198554709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walter B. Jones Woodside Treatment Center Otp 2577 W 5th St Greenville NC 27834-7813 Ph: (252) 707-5208 | Walter B. Jones Woodside Treatment Center Otp 2577 W 5th St Greenville NC 27834-7813 Ph: (252) 707-5208 |
| NPI Number | 1245892470 |
|---|---|
| Provider Enumeration Date | 07/09/2019 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Medicare PECOS PAC ID | 7315352093 |
|---|---|
| Medicare Enrollment ID | O20210210000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245892470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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