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NPI Code Detail

MEDICARE: ATS OF NORTH CAROLINA, LLC

MEDICARE: ATS OF NORTH CAROLINA, 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
1251S00000XCommunity/Behavioral Health Agency
2261QM2800XMethadone Clinic

General Provider Information

NPI Number : 1861260507
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATS OF NORTH CAROLINA, LLC
Provider Business Mailing Address
First Line : 6183 PASEO DEL NORTE STE 200
Second Line :
City : CARLSBAD
State : CA
Zip : 92011-1151
Country : US
Telephone Number : 760-710-0968
Fax Number :
Provider Business Practice Location Address
First Line : 6118 SAINT GILES ST STE 130
Second Line :
City : RALEIGH
State : NC
Zip : 27612-7099
Country : US
Telephone Number : 760-710-0968
Fax Number :
Authorized Official
Title or Position : VP & SECRETARY
Name : BRIAN PHILLIP FARLEY
Credential :
Telephone Number : 615-716-9335
Provider Enumeration Date : 12/12/2023
Last Update Date : 12/03/2024

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Directions to “ATS OF NORTH CAROLINA, LLC ” Practice Location

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