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General NPI Number Information
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NPI Number | 1033307483
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Entity Type | Organization
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Legal Business Name | NCTI AND HUMAN SERVICES
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 215 US HIGHWAY 64 W
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City | PLYMOUTH
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State | NC
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Zip | 27962-2239
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Country | US
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Telephone | 252-791-0030
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Fax | 252-791-0060
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Provider Business Mailing Address
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Address Line | 215 US HIGHWAY 64 W
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City | PLYMOUTH
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State | NC
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Zip | 27962-2239
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Country | US
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Telephone | 252-791-0030
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Fax | 252-791-0060
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. VERNON GARRISON
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Credential |
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Telephone | 252-791-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 99242
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License Number State | NC
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