Healthcare Provider Details

I. General information

NPI: 1982708095
Provider Name (Legal Business Name): CEDAR MOUNT BEHAVIORAL HEALTH, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 BLAND RD
RALEIGH NC
27609-6125
US

IV. Provider business mailing address

9650 STRICKLAND RD STE 103-432
RALEIGH NC
27615-1902
US

V. Phone/Fax

Practice location:
  • Phone: 919-417-4322
  • Fax: 919-866-1623
Mailing address:
  • Phone: 919-332-1641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number200101550
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID MBUGUA GACENGECI
Title or Position: PRESIENT
Credential: MD
Phone: 919-417-4322