Healthcare Provider Details
I. General information
NPI: 1841637261
Provider Name (Legal Business Name): COMMUNITY WORKFORCE SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2013
Last Update Date: 05/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
602 S GARNETT ST
HENDERSON NC
27536-4509
US
IV. Provider business mailing address
602 S GARNETT ST
HENDERSON NC
27536-4509
US
V. Phone/Fax
- Phone: 252-492-9555
- Fax: 252-492-6167
- Phone: 252-492-9555
- Fax: 252-492-6167
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | 091-003 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | 091-003 |
| License Number State | NC |
VIII. Authorized Official
Name: MR.
DALE
ROGER
MCGEE
Title or Position: PRESIDENT/EXECUTIVE DIRECTOR
Credential: MA
Phone: 919-231-3325