=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154472884
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF CARTERET COURTHOUSE SQUARE FINANCE OFFICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2007
-----------------------------------------------------
Last Update Date | 09/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 CRAVEN STREET
-----------------------------------------------------
City | BEAUFORT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28516-0779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-728-3181
-----------------------------------------------------
Fax | 252-728-3631
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 779 210 CRAVEN ST.
-----------------------------------------------------
City | BEAUFORT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28516-0779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-728-3181
-----------------------------------------------------
Fax | 252-648-7462
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOCIAL SERVICES DIRECTOR
-----------------------------------------------------
Name | MRS. JESSICA GARDNER ADAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-728-3181
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------