Healthcare Provider Details

I. General information

NPI: 1235276015
Provider Name (Legal Business Name): CAROLINA EASTERN HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 LAMON ST SUITE 214
FAYETTEVILLE NC
28301-4957
US

IV. Provider business mailing address

1472 BEASLEY RD
BENSON NC
27504-7486
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-6011
  • Fax: 910-321-6011
Mailing address:
  • Phone: 910-323-6011
  • Fax: 910-321-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KEN ZENG
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA
Phone: 910-323-6011