Healthcare Provider Details

I. General information

NPI: 1275107476
Provider Name (Legal Business Name): PEOPLES CHOICE BEHAVIORAL HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 N MCLEWEAN ST STE B
KINSTON NC
28501-4435
US

IV. Provider business mailing address

900 PAYLOR DR
KINSTON NC
28501-1847
US

V. Phone/Fax

Practice location:
  • Phone: 252-560-9228
  • Fax:
Mailing address:
  • Phone: 252-560-9228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CURTIS EARL HENDERSON JR.
Title or Position: CEO
Credential: LCASA
Phone: 252-560-9228