| 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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