Healthcare Provider Details

I. General information

NPI: 1689817645
Provider Name (Legal Business Name): LE CHRIS HEALTH SYSTEMS OF WILSON, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2009
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 WOOTEN BLVD SW STE. A
WILSON NC
27893-4483
US

IV. Provider business mailing address

130 JONES RD
ROCKY MOUNT NC
27804-2349
US

V. Phone/Fax

Practice location:
  • Phone: 252-243-2339
  • Fax:
Mailing address:
  • Phone: 252-451-1333
  • Fax: 252-451-1558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberNC9700116
License Number StateNC

VIII. Authorized Official

Name: MRS. SARAH H. SCHWARZ
Title or Position: PRESIDENT
Credential: MS
Phone: 252-636-6105