Healthcare Provider Details

I. General information

NPI: 1912897943
Provider Name (Legal Business Name): HEALTH OPPORTUNITIES CONSORTIUM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 FAWN TRL
JACKSONVILLE NC
28540-4595
US

IV. Provider business mailing address

109 FAWN TRL
JACKSONVILLE NC
28540-4595
US

V. Phone/Fax

Practice location:
  • Phone: 252-626-7732
  • Fax:
Mailing address:
  • Phone: 252-626-7732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA M CHITALO
Title or Position: PRESIDENT /CEO
Credential:
Phone: 252-626-7732