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General NPI Number Information
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NPI Number | 1417881715
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Entity Type | Organization
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Legal Business Name | CITIZENS BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 5540 CENTERVIEW DR
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City | RALEIGH
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State | NC
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Zip | 27606-3363
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Country | US
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Telephone | 919-633-9397
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Fax |
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Provider Business Mailing Address
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Address Line | 4220 BEACON CREST WAY
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City | RALEIGH
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State | NC
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Zip | 27604-8318
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Country | US
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Telephone | 919-633-9397
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIEL JACK
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Credential |
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Telephone | 919-633-9397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101200000X
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Taxonomy Name | Drama Therapist
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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