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General NPI Number Information
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NPI Number | 1144251828
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Entity Type | Organization
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Legal Business Name | CAROLINA COMPREHENSIVE PSYCHIATRIC SERVICES, PLLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 216 STEWART PKWY
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City | WASHINGTON
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State | NC
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Zip | 27889-4972
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Country | US
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Telephone | 252-439-1011
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Fax | 252-940-0030
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Provider Business Mailing Address
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Address Line | 1877 ALTONS TRL
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City | GREENVILLE
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State | NC
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Zip | 27834-4746
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Country | US
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Telephone | 252-439-1011
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Fax | 252-940-0030
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL ACOSTA
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Credential | MD
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Telephone | 252-439-1011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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