| Community Innovations, Inc. | |
|
410 Peanut Plant Rd Elizabethtown NC 28337-9482 | |
| (910) 862-8363 | |
| (910) 862-8767 |
| Full Name | Community Innovations, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 410 Peanut Plant Rd, Elizabethtown, North Carolina |
| Authorized Official Name and Position | Andy Anderson (PRESIDENT) |
| Authorized Official Contact | 9107398849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Innovations, Inc. 3210 Fairhill Dr Raleigh NC 27612-3215 Ph: (919) 256-0824 | Community Innovations, Inc. 410 Peanut Plant Rd Elizabethtown NC 28337-9482 Ph: (910) 862-8363 |
| NPI Number | 1275740821 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 04/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275740821 | NPI | - | NPPES |
| 8300962 | Medicaid | NC | |
| 8300962B | Medicaid | NC | |
| 8300962G | Medicaid | NC | |
| 8300962H | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
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