Healthcare Provider Details

I. General information

NPI: 1912158643
Provider Name (Legal Business Name): SANDHILLS CENTER FOR MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 SEVEN LAKES DRIVE
WEST END NC
27376-0009
US

IV. Provider business mailing address

PO BOX 9
WEST END NC
27376-0009
US

V. Phone/Fax

Practice location:
  • Phone: 910-673-9111
  • Fax: 910-673-2015
Mailing address:
  • Phone: 910-673-9111
  • Fax: 910-673-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TOMMY E. SCOTT
Title or Position: CFO
Credential:
Phone: 910-673-9111