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474 Macon Embro Rd Macon NC 27551-9285 | |
(252) 257-1380 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 474 Macon Embro Rd, Macon, North Carolina |
Authorized Official Name and Position | Cornelius Williams (PRESIDENT REGISTERED AGENT) |
Authorized Official Contact | 2522041381 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2002 Henderson NC 27536-2002 Ph: (252) 204-1381 | 474 Macon Embro Rd Macon NC 27551-9285 Ph: (252) 257-1380 |
NPI Number | 1720136963 |
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Provider Enumeration Date | 01/06/2007 |
Last Update Date | 09/25/2021 |
Certification Date | 09/25/2021 |
Identifier | Type | State | Issuer |
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1720136963 | NPI | - | NPPES |
7804755 | Medicaid | NC |