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NPI Code Detail

MEDICARE: STICK & STAY PREVENTION, INC

MEDICARE: STICK & STAY PREVENTION, 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
1101YM0800XMental Health Counselor
2251B00000XCase Management Agency
3251V00000XVoluntary or Charitable Agency
4324500000XSubstance Abuse Rehabilitation Facility
5251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1972998995
Entity Type Code : Organization
Provider Name (Legal Business Name) : STICK & STAY PREVENTION, INC
Provider Business Mailing Address
First Line : 1812 LIBERTY ST
Second Line :
City : DURHAM
State : NC
Zip : 27703-3412
Country : US
Telephone Number : 919-384-5758
Fax Number :
Provider Business Practice Location Address
First Line : 1812 LIBERTY ST
Second Line :
City : DURHAM
State : NC
Zip : 27703-2271
Country : US
Telephone Number : 919-384-5758
Fax Number : 919-680-0778
Authorized Official
Title or Position : DIRECTOR
Name : MRS. SANDRA LASSITER
Credential :
Telephone Number : 919-384-5758
Provider Enumeration Date : 04/06/2015
Last Update Date : 05/06/2024

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Directions to “STICK & STAY PREVENTION, INC ” Practice Location

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