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NPI Code Detail

MEDICARE: POSITIVE OUTLOOK SERVICE

MEDICARE: POSITIVE OUTLOOK SERVICE
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
1251S00000XCommunity/Behavioral Health Agency
2251B00000XCase Management Agency
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1447573647
Entity Type Code : Organization
Provider Name (Legal Business Name) : POSITIVE OUTLOOK SERVICE
Provider Business Mailing Address
First Line : 201 HYCO STREET
Second Line :
City : NORLINA
State : NC
Zip : 27563-7384
Country : US
Telephone Number : 252-915-5245
Fax Number :
Provider Business Practice Location Address
First Line : 120 E BELLE ST
Second Line :
City : HENDERSON
State : NC
Zip : 27536-4502
Country : US
Telephone Number : 252-915-5245
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : CASSANDRA WILLIAMS
Credential :
Telephone Number : 252-915-5245
Provider Enumeration Date : 03/02/2010
Last Update Date : 05/10/2010

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Directions to “POSITIVE OUTLOOK SERVICE ” Practice Location

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