MEDICARE: WILMINGTON TREATMENT CENTER, 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	251S00000X	Community/Behavioral Health Agency
3	282N00000X	General Acute Care Hospital	MHH0961	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0031A	OTHER	NC	BLUE CROSS PROVIDER NUMBE
2	MHL-065-026	OTHER	NC	DHHS - DIVISION OF HEALTH SERVICE REGULATION
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MHH0961	OTHER	NC	DHHS - DIVISION OF HEALTH SERVICE REGULATION

General Provider Information

NPI Number	:	1902825169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILMINGTON TREATMENT CENTER, LLC

Provider Business Mailing Address
First Line	:	4020 ASPEN GROVE DR STE 900
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-3134
Country	:	US
Telephone Number	:	615-861-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 TROY DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-7643
Country	:	US
Telephone Number	:	910-762-2727
Fax Number	:	910-762-7923

Authorized Official
Title or Position	:	VICE PRESIDENT & SECRETARY
Name	:	BRIAN FARLEY
Credential	:
Telephone Number	:	615-861-6000

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	01/20/2026

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