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1705 Tarboro St Sw Wilson NC 27893-3428 | |
| (252) 399-8040 | |
| (252) 399-8778 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1705 Tarboro St Sw, Wilson, North Carolina |
| Authorized Official Name and Position | Richard E Hudson (PRESIDENT AND CEO) |
| Authorized Official Contact | 2523998139 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1705 Tarboro St Sw Wilson NC 27893-3428 Ph: (252) 399-8040 | 1705 Tarboro St Sw Wilson NC 27893-3428 Ph: (252) 399-8040 |
| NPI Number | 1902966468 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902966468 | NPI | - | NPPES |
| 3400126S | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | H0210 (North Carolina) | Primary |
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