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NPI 1780918367

NPI 1780918367 : SILVERSTONE COMMUNITY SERVICES : POLKTON, NC

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General NPI Number Information
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    NPI Number           |    1780918367
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    Entity Type          |    Organization 
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    Legal Business Name  |    SILVERSTONE COMMUNITY SERVICES 
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Dates
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    Enumeration Date     |    09/29/2009
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    Last Update Date     |    09/29/2009
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Provider Practice Location Address
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    Address Line         |    1534 HIGHWAY 218 HWY 218
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    City                 |    POLKTON
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    State                |    NC
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    Zip                  |    28135-8792
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    Country              |    US
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    Telephone            |    704-281-4507
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 68 HWY 218
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    City                 |    POLKTON
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    State                |    NC
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    Zip                  |    28135-0068
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    Country              |    US
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    Telephone            |    704-281-4507
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MRS. DY M VANG 
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    Credential           |    
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    Telephone            |    704-281-4507
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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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