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General NPI Number Information
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NPI Number | 1588168462
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Entity Type | Organization
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Legal Business Name | PITT COUNTY COMMUNITY COLLABORATIVE ON MENTAL HEALTH AND SUBSTANCE ABU
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 1913 TURNBURY DR
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City | GREENVILLE
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State | NC
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Zip | 27858-6168
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Country | US
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Telephone | 252-368-6472
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2482
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City | GREENVILLE
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State | NC
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Zip | 27836-0482
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Country | US
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Telephone | 252-368-6472
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIMOTHY GRANT LIVENGOOD
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Credential | MSL
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Telephone | 252-368-6472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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