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General NPI Number Information
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NPI Number | 1730385386
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Entity Type | Organization
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Legal Business Name | PICASO INC
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 609 COUNTRY CLUB DRIVE SUITE D
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City | GREENVILLE
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State | NC
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Zip | 27834
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Country | US
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Telephone | 252-830-1660
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Fax | 252-757-0654
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Provider Business Mailing Address
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Address Line | PO BOX 8685
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City | GREENVILLE
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State | NC
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Zip | 27835
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Country | US
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Telephone | 252-830-1660
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Fax | 252-757-0654
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | AARON LUCIER
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Credential |
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Telephone | 252-830-1660
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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 | NC
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