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General NPI Number Information
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NPI Number | 1568639417
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Entity Type | Organization
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Legal Business Name | EMERALD ISLE BEHAVIORAL HEALTHCARE, INC.
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 1775 HIGHWAY 210 E
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City | HAMPSTEAD
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State | NC
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Zip | 28443
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Country | US
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Telephone | 910-329-1908
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Fax | 910-329-1918
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Provider Business Mailing Address
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Address Line | 1775 HIGHWAY 210 E
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City | HAMPSTEAD
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State | NC
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Zip | 28443
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Country | US
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Telephone | 910-329-1908
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Fax | 910-329-1918
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | MRS. JULIE LYNN DUKETTE
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Credential | B.A.
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Telephone | 910-581-7487
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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 |
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License Number State |
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