Healthcare Provider Details

I. General information

NPI: 1134262306
Provider Name (Legal Business Name): PREPARING ADULTS AND CHILDREN TO EXCEL (PACE) INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 HILLSTONE PL
JAMESTOWN NC
27282-2000
US

IV. Provider business mailing address

213 HILLSTONE PL
JAMESTOWN NC
27282-2000
US

V. Phone/Fax

Practice location:
  • Phone: 336-905-7410
  • Fax: 336-905-7416
Mailing address:
  • Phone: 336-905-7410
  • Fax: 336-905-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS HARRIETT REID-BELL
Title or Position: PRESIDENT
Credential: MASTERS COUNSELING
Phone: 336-905-7410