Healthcare Provider Details

I. General information

NPI: 1336414572
Provider Name (Legal Business Name): URBAN HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 ROCKINGHAM RD STE 4
ROCKINGHAM NC
28379-4925
US

IV. Provider business mailing address

755 S MAIN ST
RAEFORD NC
28376-3238
US

V. Phone/Fax

Practice location:
  • Phone: 910-633-7503
  • Fax:
Mailing address:
  • Phone: 910-848-0464
  • Fax: 910-848-0492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. EDWARD LAMAR GRIER JR.
Title or Position: CEO
Credential:
Phone: 910-848-0464