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Behavioral Health & Social Service Providers Counselor

Provider NPI: 1417370818

Organization Information:
Organization is not Subpart
Authorized Official:  MICHELE S BOWERSOX  OFFICE ADMINISTRATOR  704-202-2056

Practice Location:
Tel: 704-279-0626  Fax: 704-279-0344

Business Mailing Address:
PO BOX 271  ROCKWELL, NC 28138-0271 US
Tel: 704-202-2056  Fax: 704-279-0344

NPI Information:
NPI: 1417370818
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N101Y00000XBehavioral Health & Social Service Providers
Community/Behavioral Health
N101YM0800XBehavioral Health & Social Service Providers
N101YP2500XBehavioral Health & Social Service Providers
N103T00000XBehavioral Health & Social Service Providers
Y103T00000XBehavioral Health & Social Service Providers

Other Provider Identifiers:

NPI TYPE 1144753679201

American Medical Association 2012 taxonomy code information

Code: 103T00000X





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