Healthcare Provider Details

I. General information

NPI: 1689750663
Provider Name (Legal Business Name): ADVANTAGE BEHAVIORAL HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 DAVIS AVENUE
WHITEVILLE NC
28472-6002
US

IV. Provider business mailing address

PO BOX 1383
WHITEVILLE NC
28472-1383
US

V. Phone/Fax

Practice location:
  • Phone: 910-640-1038
  • Fax: 910-640-1465
Mailing address:
  • Phone: 910-640-1038
  • Fax: 910-640-1465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH CLYDE HUNT
Title or Position: CEO
Credential:
Phone: 910-640-1038