Healthcare Provider Details

I. General information

NPI: 1932365178
Provider Name (Legal Business Name): STANDARDS-BASED SOLUTIONS NC BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19210 STONE BRK
CHAPEL HILL NC
27517-8349
US

IV. Provider business mailing address

510 MEADOWMONT VILLAGE CIR
CHAPEL HILL NC
27517-7584
US

V. Phone/Fax

Practice location:
  • Phone: 919-967-5429
  • Fax:
Mailing address:
  • Phone: 919-967-5429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MILDRED SHAW JOHNSON
Title or Position: PRESIDENT/CEO
Credential: MA, MSW
Phone: 919-672-4472