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General NPI Number Information
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NPI Number | 1376673699
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH ASSOCIATION OF NC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 613 TABORO STREET
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City | WASHINGTON
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State | NC
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Zip | 27889-4181
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Country | US
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Telephone | 252-975-6666
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Fax | 252-975-6319
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Provider Business Mailing Address
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Address Line | 613 TARBORO ST
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City | WASHINGTON
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State | NC
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Zip | 27889-4181
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Country | US
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Telephone | 252-975-6666
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Fax | 252-975-6319
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | MR. BOBBY E HYMAN
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Credential | BA
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Telephone | 252-975-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NC
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