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NPI Code Detail

MEDICARE: SOUTHEASTERN BEHAVIORAL HEALTHCARE SERVICES

MEDICARE: SOUTHEASTERN BEHAVIORAL HEALTHCARE SERVICES
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
11041C0700XClinical Social WorkerC00269NC
2251S00000XCommunity/Behavioral Health Agency

Other Identifiers

General Provider Information

NPI Number : 1932304714
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEASTERN BEHAVIORAL HEALTHCARE SERVICES
Provider Business Mailing Address
First Line : PO BOX 1004
Second Line :
City : LUMBERTON
State : NC
Zip : 28359-1004
Country : US
Telephone Number : 910-738-1587
Fax Number : 910-738-1581
Provider Business Practice Location Address
First Line : 3581 LACKEY ST
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-9048
Country : US
Telephone Number : 910-738-1587
Fax Number : 910-738-1581
Authorized Official
Title or Position : CEO
Name : VIRGIL L HUTCHINSON
Credential :
Telephone Number : 910-738-1587
Provider Enumeration Date : 06/20/2007
Last Update Date : 06/25/2012

Similar Medicare Providers

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1720277767 — DARRYL X MCALLISTER PHD, LCSW
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Practice Location Address:
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1992058721 — BERTHA MCLEAN HUTCHINSON
Practice Location Address:
3581 LACKEY ST
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Practice Fax: 910-738-1581

Directions to “SOUTHEASTERN BEHAVIORAL HEALTHCARE SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.