Provider Demographics
NPI:1033741939
Name:PARKTON PLANTATION
Entity Type:Organization
Organization Name:PARKTON PLANTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:910-494-5888
Mailing Address - Street 1:1860 ARMORY RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:NC
Mailing Address - Zip Code:28371-8436
Mailing Address - Country:US
Mailing Address - Phone:910-494-5888
Mailing Address - Fax:910-920-9113
Practice Address - Street 1:1860 ARMORY RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:NC
Practice Address - Zip Code:28371-8436
Practice Address - Country:US
Practice Address - Phone:910-494-5888
Practice Address - Fax:910-920-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty