| Halifax Actt | |
|
622 Roanoke Ave Ste D Roanoke Rapids NC 27870-2740 | |
| (252) 410-0111 | |
| Not Available |
| Full Name | Halifax Actt |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 622 Roanoke Ave Ste D, Roanoke Rapids, North Carolina |
| Authorized Official Name and Position | Kevin L Cochran (FINANCIAL ASSISTANT) |
| Authorized Official Contact | 9199810740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Halifax Actt 1331 Sunday Dr Raleigh NC 27607 Ph: (919) 981-0740 | Halifax Actt 622 Roanoke Ave Ste D Roanoke Rapids NC 27870-2740 Ph: (252) 410-0111 |
| NPI Number | 1205962115 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 09/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205962115 | NPI | - | NPPES |
| 8300430G | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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