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NPI Code Detail

MEDICARE: BETHESDA INC

MEDICARE: BETHESDA INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation FacilityMHL 063002NC

General Provider Information

NPI Number : 1134206204
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETHESDA INC
Provider Business Mailing Address
First Line : 204 NORTH PINE STREET
Second Line :
City : ABERDEEN
State : NC
Zip : 28315-2732
Country : US
Telephone Number : 910-944-7700
Fax Number : 910-944-7099
Provider Business Practice Location Address
First Line : 204 NORTH PINE STREET
Second Line :
City : ABERDEEN
State : NC
Zip : 28315-2732
Country : US
Telephone Number : 910-944-7700
Fax Number : 910-944-7099
Authorized Official
Title or Position : DIRECTOR
Name : MR. E GLENN GREENE
Credential : LICENSED CLINICAL AD
Telephone Number : 910-944-7700
Provider Enumeration Date : 11/01/2006
Last Update Date : 09/21/2011

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Directions to “BETHESDA INC ” Practice Location

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