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General NPI Number Information
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NPI Number | 1154697266
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Entity Type | Organization
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Legal Business Name | HEALTHCORE RESOURCE INC
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 1831 WEEKSVILLE RD SUITE L
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-7721
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Country | US
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Telephone | 919-872-1178
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Fax | 919-872-1170
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Provider Business Mailing Address
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Address Line | 1001 NAVAHO DR STE 210
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City | RALEIGH
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State | NC
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Zip | 27609-7318
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Country | US
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Telephone | 919-872-1178
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Fax | 919-872-1170
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Authorized Official
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Title or Position | QM DIRECTOR
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Name | IJEOMA NWAEZE
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Credential |
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Telephone | 919-872-1178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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