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General NPI Number Information
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NPI Number | 1225473572
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Entity Type | Organization
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Legal Business Name | FOUR COUNTIES
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 1310 NIBLICK DR
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-8652
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Country | US
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Telephone | 252-903-6566
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Fax |
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Provider Business Mailing Address
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Address Line | 107 S TIMBER PL
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City | DUDLEY
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State | NC
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Zip | 28333-5389
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Country | US
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Telephone | 919-921-6299
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ANNA MARGARET BATTLE
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Credential |
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Telephone | 919-921-6299
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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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