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General NPI Number Information
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NPI Number | 1598824302
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Entity Type | Organization
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Legal Business Name | S&M GROUP SERVICES OF PITT COUNTY, LLC
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 1206 SOUTH EVANS ST.
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City | GREENVILLE
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State | NC
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Zip | 27834-4102
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Country | US
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Telephone | 252-830-2100
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Fax | 252-830-2101
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Provider Business Mailing Address
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Address Line | 1206 SOUTH EVANS ST.
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City | GREENVILLE
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State | NC
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Zip | 27834-4102
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Country | US
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Telephone | 252-830-2100
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Fax | 252-830-2101
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Authorized Official
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Title or Position | PRESIDENT
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Name | TYMESHIE JEMEL FRANKLIN
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Credential |
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Telephone | 252-830-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-074-171
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License Number State | NC
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