| Johnston County Industries, Inc. | |
| 112 E Richardson St Selma NC 27576-2606 | |
| (919) 965-6892 | |
| Not Available | 
| Full Name | Johnston County Industries, Inc. | 
|---|---|
| Speciality | Community/behavioral Health | 
| Location | 112 E Richardson St, Selma, North Carolina | 
| Authorized Official Name and Position | Vicki R Shore (EXECUTIVE DIRECTOR) | 
| Authorized Official Contact | 9197438702 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Johnston County Industries, Inc. 1100 E Preston St Selma NC 27576-3162 Ph: (919) 743-8709 | Johnston County Industries, Inc. 112 E Richardson St Selma NC 27576-2606 Ph: (919) 965-6892 | 
| NPI Number | 1649443953 | 
|---|---|
| Provider Enumeration Date | 04/08/2008 | 
| Last Update Date | 08/26/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1649443953 | NPI | - | NPPES | 
| 8302099 | Medicaid | NC | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-051-162 (North Carolina) | Primary | 
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