Organization · NPI-2

Innovative Programming Associates, INC.

Clinic/Center, Mental Health (Including Community Mental Health Center) · Elizabeth City, NC

NPI number1063470656
StatusActive
Last updated in NPPESDec 7, 2007

Details

NPI
1063470656
Entity type
Organization (NPI-2)
Legal business name
Innovative Programming Associates, INC.
Organization subpart
No
Enumeration date
May 3, 2006
Last updated
Dec 7, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)–NCYes
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder–NC
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities–NC
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities–NC
324500000X Substance Abuse Rehabilitation Facility–NC

Practice location

1134 N Road St Ste 6
Elizabeth City, NC 27909-3365

Phone 252-338-9005 · Fax 252-338-9007

Mailing address

111 Lamon St
Fayetteville, NC 28301-4957

Phone 910-483-0734 · Fax 910-483-9403

Authorized official

Leslie Coley
Billing Supervisor
9104830734

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