| The Enhancement Center - Clayton | |
|
896 Gulley Dr Clayton NC 27520-2189 | |
| (919) 359-8167 | |
| (919) 212-8581 |
| Full Name | The Enhancement Center - Clayton |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 896 Gulley Dr, Clayton, North Carolina |
| Authorized Official Name and Position | Juliet Okwoshah (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9198193882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Enhancement Center - Clayton 896 Gulley Dr Clayton NC 27520-2189 Ph: (919) 243-8906 | The Enhancement Center - Clayton 896 Gulley Dr Clayton NC 27520-2189 Ph: (919) 359-8167 |
| NPI Number | 1396004602 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Medicare PECOS PAC ID | 4183079064 |
|---|---|
| Medicare Enrollment ID | O20231012001776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396004602 | NPI | - | NPPES |
| 8303479 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-051-200 (North Carolina) | Primary |
| Provider Name | Paul Ilolibi Medju |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407214919 PECOS PAC ID: 4082097365 Enrollment ID: I20220818003557 |
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