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General NPI Number Information
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NPI Number | 1710141122
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Entity Type | Organization
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Legal Business Name | STEVENS HEALTHCARE AGENCY, INC.
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 824 GUM BRANCH ROAD SUITE N
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City | JACKSONVILLE
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State | NC
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Zip | 28540-6269
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Country | US
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Telephone | 910-938-7200
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Fax | 910-938-7201
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Provider Business Mailing Address
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Address Line | 824 GUM BRANCH ROAD SUITE N
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City | JACKSONVILLE
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State | NC
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Zip | 28540-6269
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Country | US
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Telephone | 910-938-7200
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Fax | 910-938-7201
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | MRS. LINDA FREEMAN STEVENS
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Credential | BS, MA, QP, PHD
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Telephone | 910-938-7200
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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 | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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Taxonomy #3
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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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