Healthcare Provider Details
I. General information
NPI: 1902951163
Provider Name (Legal Business Name): ALBEMARLE MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
160-A CAMDEN MEDICAL PARK
CAMDEN NC
27921
US
IV. Provider business mailing address
160-A CAMDEN MEDICAL PARK
CAMDEN NC
27921
US
V. Phone/Fax
- Phone: 252-335-5158
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARLES
FRANKLIN
JR.
Title or Position: AREA DIRECTOR
Credential:
Phone: 252-335-1113