MEDICARE: DIMENSIONS HEALTHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP0905X	State or Local Public Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225076615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIMENSIONS HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	1421C S GLENBURNIE RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2603
Country	:	US
Telephone Number	:	252-637-1226
Fax Number	:	252-637-7422

Provider Business Practice Location Address
First Line	:	1421C S GLENBURNIE RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2603
Country	:	US
Telephone Number	:	252-637-1226
Fax Number	:	252-637-7422

Authorized Official
Title or Position	:	DIRECTOR/MANAGER
Name	:	MRS. TANYA P. ROBERTS
Credential	:	M.S.W.
Telephone Number	:	252-637-1226

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	08/22/2020

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