Organization · NPI-2

Redesigning Life Of N.C.,ll

Clinic/Center, Adult Mental Health · Wilson, NC

NPI number1366729048
StatusActive
Last updated in NPPESNov 9, 2011

Details

NPI
1366729048
Entity type
Organization (NPI-2)
Legal business name
Redesigning Life Of N.C.,ll
Organization subpart
Yes
Enumeration date
Nov 9, 2011
Last updated
Nov 9, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental HealthMHL-098-173NCYes

Practice location

806 Tarboro St W
Suite A
Wilson, NC 27893-4771

Phone 252-363-4122 · Fax 252-296-0033

Mailing address

Po Box 683
Wilson, NC 27894-0683

Phone 252-363-4122 · Fax 252-296-0033

Authorized official

Chandra Revis Pegues
Director/Owner
2523634122

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