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General NPI Number Information
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NPI Number | 1023096088
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Entity Type | Organization
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Legal Business Name | WELLSPRINGS CENTER OF GOLDSBORO,P.A.
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 2719 GRAVES DR SUITE 7
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City | GOLDSBORO
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State | NC
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Zip | 27534-4536
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Country | US
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Telephone | 919-583-8448
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Fax | 919-583-8449
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Provider Business Mailing Address
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Address Line | 2719 GRAVES DR SUITE 7
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City | GOLDSBORO
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State | NC
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Zip | 27534-4536
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Country | US
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Telephone | 919-583-8448
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Fax | 919-583-8449
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAMARA TYNDALL JARMAN
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Credential | LCSW
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Telephone | 919-583-8448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NC
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