| Community Intervention Services Agency | |
|
300 W 27th St Lumberton NC 28358-3075 | |
| (910) 671-5000 | |
| (910) 671-5858 |
| Full Name | Community Intervention Services Agency |
|---|---|
| Speciality | Clinic/center |
| Location | 300 W 27th St, Lumberton, North Carolina |
| Authorized Official Name and Position | C. Thomas Johnson (V.P. FINANCE) |
| Authorized Official Contact | 9106715090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Intervention Services Agency 300 W 27th St Lumberton NC 28358-3075 Ph: (910) 671-5000 | Community Intervention Services Agency 300 W 27th St Lumberton NC 28358-3075 Ph: (910) 671-5000 |
| NPI Number | 1942261714 |
|---|---|
| Provider Enumeration Date | 03/31/2006 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942261714 | NPI | - | NPPES |
| 8300343 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | H0064 (North Carolina) | Primary |
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