Healthcare Provider Details

I. General information

NPI: 1134568736
Provider Name (Legal Business Name): ZAK BEHAVIORAL HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 MERCANTILE DR
LELAND NC
28451-4053
US

IV. Provider business mailing address

PO BOX 16149
WILMINGTON NC
28408-6149
US

V. Phone/Fax

Practice location:
  • Phone: 910-232-3852
  • Fax: 910-502-5033
Mailing address:
  • Phone: 910-232-3852
  • Fax: 910-502-5033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SAKA SALAMI
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 910-232-3852