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General NPI Number Information
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NPI Number | 1699130773
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Entity Type | Organization
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Legal Business Name | APEX SELECT
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 331 E MAIN ST STE 200
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City | ROCK HILL
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State | SC
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Zip | 29730-5371
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Country | US
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Telephone | 443-440-7018
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S ELM ST STE 125
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City | GREENSBORO
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State | NC
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Zip | 27401-2698
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Country | US
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Telephone | 443-440-7018
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RODNEY BLACKSTOCK
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Credential |
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Telephone | 443-440-7018
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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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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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