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General NPI Number Information
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NPI Number | 1386707644
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Entity Type | Organization
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Legal Business Name | BENJAMIN HOUSE, INC.
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1221 CAROLINA AVE SUITE 3
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-5407
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Country | US
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Telephone | 252-331-7731
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Fax | 252-331-1777
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Provider Business Mailing Address
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Address Line | 1221 CAROLINA AVE SUITE 3
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-5407
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Country | US
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Telephone | 252-331-7731
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Fax | 252-331-1777
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DAVID E. GILBERT
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Credential |
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Telephone | 252-338-0333
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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 | 8300836B
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License Number State | NC
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