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General NPI Number Information
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NPI Number | 1407188832
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Entity Type | Organization
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Legal Business Name | UNIFIED BEHAVIORAL HEALTH, INC
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Dates
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Enumeration Date | 02/10/2010
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 139 W 3RD ST
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City | WASHINGTON
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State | NC
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Zip | 27889-4970
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Country | US
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Telephone | 252-402-7298
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Fax | 252-940-7261
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Provider Business Mailing Address
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Address Line | 139 W 3RD ST
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City | WASHINGTON
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State | NC
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Zip | 27889-4970
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Country | US
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Telephone | 252-402-7298
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Fax | 252-940-7261
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Authorized Official
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Title or Position | CEO
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Name | MRS. LATISHA MOORE
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Credential | BS
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Telephone | 252-402-7298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-007-062
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License Number State | NC
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Taxonomy #4
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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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