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General NPI Number Information
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NPI Number | 1780883959
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Entity Type | Organization
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Legal Business Name | PALMER PREVENTION, INC.
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 208 N. MAIN ST.
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City | PEMBROKE
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State | NC
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Zip | 28372-3959
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Country | US
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Telephone | 910-522-0421
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Fax | 910-522-1169
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Provider Business Mailing Address
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Address Line | PO BOX 3959
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City | PEMBROKE
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State | NC
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Zip | 28372-3959
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Country | US
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Telephone | 910-522-0421
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Fax | 910-522-1169
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Authorized Official
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Title or Position | EX. DIRECTOR
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Name | MR. THOMAS GRAHAM NORTON
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Credential | LCAS, CCS
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Telephone | 910-522-0421
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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 | MHL-078-194
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | MHL-078-194
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License Number State | NC
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