Port Health Services
Substance Abuse Rehabilitation Facility in Ahoskie, NC. Organization (NPI-2).
NPI number1154473239
StatusActive
Last updated in NPPESMay 15, 2023
Details
- NPI
- 1154473239
- Entity type
- Organization (NPI-2)
- Legal business name
- Port Health Services
- Organization subpart
- No
- Enumeration date
- Jan 17, 2007
- Certification date
- May 15, 2023
- Last updated
- May 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | MHL-046-015 | NC | Yes |
| 251S00000X | Community/Behavioral Health | – | – |
Other names
- Port Human Services (Former Legal Business Name)
Practice location
144 Community College Rd Ste CAhoskie, NC 27910-8047
Phone 252-332-5086 · Fax 252-332-5243
Mailing address
4300 Sapphire Ct Ste 110Greenville, NC 27834-9079
Phone 252-830-7540 · Fax 252-413-0932
Authorized official
Brett Beavers
Credentialing Manager
9192107661
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