Provider Demographics
NPI:1164623237
Name:JOURNEY TOWARDS IMPROVED HEALTH
Entity Type:Organization
Organization Name:JOURNEY TOWARDS IMPROVED HEALTH
Other - Org Name:JOURNEY TOWARDS IMPROVED HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INDEPENT PRACTIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCHHC
Authorized Official - Phone:336-312-3818
Mailing Address - Street 1:108 CARVER DR
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-1302
Mailing Address - Country:US
Mailing Address - Phone:336-312-3818
Mailing Address - Fax:336-450-4358
Practice Address - Street 1:108 N FRANKLIN ST STE A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NC
Practice Address - Zip Code:27025-1968
Practice Address - Country:US
Practice Address - Phone:336-312-3818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 171M00000X, 2084P0800X, 251S00000X
NCMHL041818251S00000X
NCMHL-041-866322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301990Medicaid
NC1164623237Medicaid
NC8301990HMedicaid
NC8301990GMedicaid
NC6006886Medicaid
NC6604313Medicaid
NC8301990BMedicaid
NC1164623237OtherMEDICAID
NC6604184Medicaid