Healthcare Provider Details

I. General information

NPI: 1942350053
Provider Name (Legal Business Name): PORT HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 FOREST HILLS RD W STE A
WILSON NC
27893-3483
US

IV. Provider business mailing address

2245 STANTONSBURG RD SUITE P
GREENVILLE NC
27834-2868
US

V. Phone/Fax

Practice location:
  • Phone: 252-237-1037
  • Fax: 252-237-2190
Mailing address:
  • Phone: 252-752-0483
  • Fax: 252-752-2971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: THOMAS O SAVIDGE
Title or Position: CEO
Credential:
Phone: 252-752-0483