Healthcare Provider Details

I. General information

NPI: 1558683599
Provider Name (Legal Business Name): UNIVERSAL MENTAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 WRIGHTSVILLE AVE STE 23
WILMINGTON NC
28403-8463
US

IV. Provider business mailing address

839 WILKESBORO BLVD NE
LENOIR NC
28645-4612
US

V. Phone/Fax

Practice location:
  • Phone: 910-399-4303
  • Fax: 910-399-4304
Mailing address:
  • Phone: 828-759-2228
  • Fax: 828-759-0159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BROOK PHILLIPS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 828-759-4064