Provider Demographics
NPI:1063645133
Name:ATLANTIC HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:ATLANTIC HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUANA
Authorized Official - Middle Name:ASANGONO
Authorized Official - Last Name:NJOKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-696-0020
Mailing Address - Street 1:100 MEREDITH DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5237
Mailing Address - Country:US
Mailing Address - Phone:919-696-0020
Mailing Address - Fax:
Practice Address - Street 1:100 MEREDITH DR
Practice Address - Street 2:SUITE 180
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5237
Practice Address - Country:US
Practice Address - Phone:919-696-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health