Provider Demographics
NPI:1043459019
Name:STARTING OVER INC.
Entity Type:Organization
Organization Name:STARTING OVER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO - EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:LYNNETTE
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-334-9624
Mailing Address - Street 1:915 W. EHRINGHAUS STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3362
Mailing Address - Country:US
Mailing Address - Phone:252-334-9624
Mailing Address - Fax:
Practice Address - Street 1:915 W EHRINGHAUS ST
Practice Address - Street 2:SUITE E
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-7042
Practice Address - Country:US
Practice Address - Phone:252-334-9624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========Medicaid