| Spring Life Behavioral Care Llc | |
|
109 Long Cir Roanoke Rapids NC 27870-3162 | |
| (252) 535-6400 | |
| (252) 535-6401 |
| Full Name | Spring Life Behavioral Care Llc |
|---|---|
| Speciality | Non-emergency Medical Transport (VAN) |
| Location | 109 Long Cir, Roanoke Rapids, North Carolina |
| Authorized Official Name and Position | Chisom Atufunwa (OWNER) |
| Authorized Official Contact | 9194511618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring Life Behavioral Care Llc 200 Becker Dr Roanoke Rapids NC 27870-3134 Ph: (252) 535-6400 | Spring Life Behavioral Care Llc 109 Long Cir Roanoke Rapids NC 27870-3162 Ph: (252) 535-6400 |
| NPI Number | 1316265614 |
|---|---|
| Provider Enumeration Date | 05/11/2010 |
| Last Update Date | 06/01/2023 |
| Certification Date | 06/01/2023 |
| Medicare PECOS PAC ID | 9032428875 |
|---|---|
| Medicare Enrollment ID | O20151019001751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316265614 | NPI | - | NPPES |
| Provider Name | Florence O Ikechukwu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457514275 PECOS PAC ID: 6901082585 Enrollment ID: I20110516000653 |
| Provider Name | Jewel M Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972875755 PECOS PAC ID: 6002077831 Enrollment ID: I20120420000681 |
| Provider Name | Joy U Atufunwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306457536 PECOS PAC ID: 4486064557 Enrollment ID: I20210510001127 |
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