Healthcare Provider Details

I. General information

NPI: 1528314903
Provider Name (Legal Business Name): METROPOLITAN HOMECARE AND BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W MARTIN LUTHER KING JR DR
WASHINGTON NC
27889-4906
US

IV. Provider business mailing address

120 W MARTIN LUTHER KING JR DR
WASHINGTON NC
27889-4906
US

V. Phone/Fax

Practice location:
  • Phone: 252-940-0602
  • Fax:
Mailing address:
  • Phone: 252-940-0602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number0000000000
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number00000000
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number000000000
License Number StateNC

VIII. Authorized Official

Name: MELINDA MOORE
Title or Position: DIRECTOR
Credential:
Phone: 252-940-0600