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General NPI Number Information
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NPI Number | 1750433728
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Entity Type | Organization
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Legal Business Name | EAST CAROLINA UNIVERSITY HORIZONS
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 174 MINGES COLISEUM ECU RCLS DEPT.
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City | GREENVILLE
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State | NC
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Zip | 27858-4353
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Country | US
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Telephone | 252-328-4640
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Fax | 252-328-4642
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Provider Business Mailing Address
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Address Line | BELK ANNEX 4 ECU RCLS DEPARTMENT-ECU HORIZONS
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City | GREENVILLE
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State | NC
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Zip | 27858-4353
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Country | US
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Telephone | 252-328-4640
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Fax | 252-328-4642
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. THOMAS K. SKALKO
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Credential | PH.D.
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Telephone | 252-328-0018
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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 | MHL074127
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License Number State | NC
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