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General NPI Number Information
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NPI Number | 1508992074
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Entity Type | Organization
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Legal Business Name | CAROLINA COMPREHENSIVE SERVICES, LLC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 312 W MILLBROOK RD SUITE 137
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City | RALEIGH
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State | NC
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Zip | 27609-4389
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Country | US
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Telephone | 919-847-0550
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Fax | 919-847-0599
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Provider Business Mailing Address
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Address Line | 312 W MILLBROOK RD SUITE 137
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City | RALEIGH
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State | NC
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Zip | 27609-4389
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Country | US
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Telephone | 919-847-0550
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Fax | 919-847-0599
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Authorized Official
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Title or Position | OWNER,CLINICAL DIRECTOR
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Name | MS. MONDAH TIANGAI PARKINSON
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Credential |
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Telephone | 704-507-7674
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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 | 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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