Healthcare Provider Details

I. General information

NPI: 1043564677
Provider Name (Legal Business Name): INSIGHT HUMAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 06/06/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 W 4TH ST
WINSTON SALEM NC
27101-2701
US

IV. Provider business mailing address

665 W 4TH ST
WINSTON SALEM NC
27101-2701
US

V. Phone/Fax

Practice location:
  • Phone: 336-725-8389
  • Fax: 336-652-6277
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number011-026
License Number StateNC

VIII. Authorized Official

Name: JAMES ROGER HARNER
Title or Position: CEO
Credential:
Phone: 336-725-8389