| Fayetteville | |
|
2248 Wingate Rd Fayetteville NC 28304-1336 | |
| (910) 424-2121 | |
| (910) 424-7045 |
| Full Name | Fayetteville |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2248 Wingate Rd, Fayetteville, North Carolina |
| Authorized Official Name and Position | Jennifer D Lozano (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 4043642900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fayetteville 1819 Peachtree Rd Ne Ste 450 Atlanta GA 30309-1848 Ph: (404) 364-2900 | Fayetteville 2248 Wingate Rd Fayetteville NC 28304-1336 Ph: (910) 424-2121 |
| NPI Number | 1326245473 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 09/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326245473 | NPI | - | NPPES |
| 8300394J | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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