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General NPI Number Information
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NPI Number | 1972653004
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Entity Type | Organization
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Legal Business Name | PORT HUMAN SERVICES
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3007 N MAIN ST
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City | TARBORO
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State | NC
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Zip | 27886-1922
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Country | US
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Telephone | 252-823-6031
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Fax | 252-823-2616
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Provider Business Mailing Address
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Address Line | 2245 STANTONSBURG RD SUITE P
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City | GREENVILLE
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State | NC
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Zip | 27834-2868
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Country | US
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Telephone | 252-752-0483
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Fax | 252-752-2971
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Authorized Official
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Title or Position | CEO
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Name | THOMAS O SAVIDGE
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Credential |
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Telephone | 252-752-0483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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