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General NPI Number Information
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NPI Number | 1992062483
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Entity Type | Organization
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Legal Business Name | CAROLINA COMMUNITY SERVICES
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 04/20/2012
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Provider Practice Location Address
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Address Line | 701 E YOUNG ST
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City | ROLESVILLE
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State | NC
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Zip | 27571-9458
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Country | US
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Telephone | 919-569-9566
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Fax | 919-569-0269
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Provider Business Mailing Address
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Address Line | PO BOX 1383
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City | WENDELL
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State | NC
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Zip | 27591-1383
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. BRENDEX RENEA MEEKS
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Credential |
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Telephone | 919-390-4429
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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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