| Statewide Mental Health & Disability Services Pllc | |
|
622 Roanoke Ave Ste A Roanoke Rapids NC 27870-2740 | |
| (252) 308-1247 | |
| Not Available |
| Full Name | Statewide Mental Health & Disability Services Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 622 Roanoke Ave Ste A, Roanoke Rapids, North Carolina |
| Authorized Official Name and Position | Kristin Clayton (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2523081247 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Statewide Mental Health & Disability Services Pllc 730 Roanoke Avenue Suite A-1 Roanoke Rapids NC 27870-2740 Ph: (252) 308-1247 | Statewide Mental Health & Disability Services Pllc 622 Roanoke Ave Ste A Roanoke Rapids NC 27870-2740 Ph: (252) 308-1247 |
| NPI Number | 1588942239 |
|---|---|
| Provider Enumeration Date | 07/29/2011 |
| Last Update Date | 07/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588942239 | NPI | - | NPPES |
| 6003794 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | COO3950 (North Carolina) | Primary |
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