MEDICARE: CAPE FEAR COUNCIL OF GOVERNMENTS

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
1	171M00000X	Case Manager/Care Coordinator
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1780575829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPE FEAR COUNCIL OF GOVERNMENTS

Provider Business Mailing Address
First Line	:	1480 HARBOUR DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-7742
Country	:	US
Telephone Number	:	910-395-4553
Fax Number	:	910-395-2684

Provider Business Practice Location Address
First Line	:	1480 HARBOUR DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-7742
Country	:	US
Telephone Number	:	910-395-4553
Fax Number	:	910-395-2684

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ALLEN SERKIN
Credential	:
Telephone Number	:	910-395-4553

Provider Enumeration Date	:	07/15/2025
Last Update Date	:	07/15/2025

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