| C-blac Services, Inc. | |
|
1300 W Market St Smithfield NC 27577-3339 | |
| (919) 989-1786 | |
| (919) 989-1791 |
| Full Name | C-blac Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1300 W Market St, Smithfield, North Carolina |
| Authorized Official Name and Position | Janet M Wise (CEO) |
| Authorized Official Contact | 9199891786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C-blac Services, Inc. 1302 W Market St Smithfield NC 27577-3339 Ph: (919) 989-1786 | C-blac Services, Inc. 1300 W Market St Smithfield NC 27577-3339 Ph: (919) 989-1786 |
| NPI Number | 1184761660 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 09/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184761660 | NPI | - | NPPES |
| 5901780 | Medicaid | NC | |
| 6005614 | Medicaid | NC | |
| 6600860 | Medicaid | NC | |
| 8301075 | Medicaid | NC | |
| 8700356 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL 051 128 (North Carolina) | Primary |
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