Provider Demographics
NPI:1073297156
Name:COMP SERV HEALTH RESOURCES NORTH CAROLINA
Entity Type:Organization
Organization Name:COMP SERV HEALTH RESOURCES NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NIANG
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LCAS CCS
Authorized Official - Phone:910-352-0733
Mailing Address - Street 1:3971 BUSINESS 17 E
Mailing Address - Street 2:
Mailing Address - City:BOLIVIA
Mailing Address - State:NC
Mailing Address - Zip Code:28422-8675
Mailing Address - Country:US
Mailing Address - Phone:888-751-3730
Mailing Address - Fax:502-792-9184
Practice Address - Street 1:3971 BUSINESS 17 E
Practice Address - Street 2:
Practice Address - City:BOLIVIA
Practice Address - State:NC
Practice Address - Zip Code:28422-8675
Practice Address - Country:US
Practice Address - Phone:888-751-3730
Practice Address - Fax:502-792-9184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty