| Carolina Residential Services, Inc. | |
|
714 Simmons St Goldsboro NC 27530-3843 | |
| (919) 580-0020 | |
| (919) 580-0026 |
| Full Name | Carolina Residential Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 714 Simmons St, Goldsboro, North Carolina |
| Authorized Official Name and Position | Susan M Kincaid (DIRECTOR/OWNER) |
| Authorized Official Contact | 8284133786 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Residential Services, Inc. Po Box 286 Rutherford College NC 28671-0286 Ph: (828) 572-2333 | Carolina Residential Services, Inc. 714 Simmons St Goldsboro NC 27530-3843 Ph: (919) 580-0020 |
| NPI Number | 1619242518 |
|---|---|
| Provider Enumeration Date | 03/12/2012 |
| Last Update Date | 03/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619242518 | NPI | - | NPPES |
| 8303429S | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-096-005 (North Carolina) | Primary |
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