| Iquolioc, Inc. | |
|
675 Bell Fork Rd Jacksonville NC 28540-6315 | |
| (910) 355-2000 | |
| (910) 355-3047 |
| Full Name | Iquolioc, Inc. |
|---|---|
| Speciality | Case Management |
| Location | 675 Bell Fork Rd, Jacksonville, North Carolina |
| Authorized Official Name and Position | Tammy Cleveland (PRESIDENT) |
| Authorized Official Contact | 9103552000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iquolioc, Inc. 675 Bell Fork Rd Jacksonville NC 28540-6315 Ph: (910) 355-2000 | Iquolioc, Inc. 675 Bell Fork Rd Jacksonville NC 28540-6315 Ph: (910) 355-2000 |
| NPI Number | 1295904001 |
|---|---|
| Provider Enumeration Date | 02/26/2008 |
| Last Update Date | 02/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295904001 | NPI | - | NPPES |
| 8301171 | Medicaid | NC | |
| 8301171B | Medicaid | NC | |
| 3409548 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0700012694 (North Carolina) | Secondary |
| 251B00000X | Case Management | 0700012694 (North Carolina) | Primary |
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