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General NPI Number Information
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NPI Number | 1467513440
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Entity Type | Organization
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Legal Business Name | CAMBRIDGE BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 809 W END ST
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City | ROCKY MOUNT
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State | NC
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Zip | 27803-2819
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Country | US
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Telephone | 252-442-9693
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Fax | 252-353-4228
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Provider Business Mailing Address
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Address Line | 622 S MEMORIAL DR
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City | GREENVILLE
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State | NC
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Zip | 27834-2854
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Country | US
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Telephone | 252-353-4250
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Fax | 252-353-4228
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. HATTIE FAYE BORDEAUX
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Credential | LCSW
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Telephone | 252-353-4250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MHL-064-069
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License Number State | NC
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