Provider Demographics
NPI:1164872750
Name:MORSE CLINIC OF NORTH RALEIGH, PC
Entity Type:Organization
Organization Name:MORSE CLINIC OF NORTH RALEIGH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPONSOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:DALTON
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-673-9681
Mailing Address - Street 1:3209 GRESHAM LAKE RD
Mailing Address - Street 2:BUILDING 10, SUITE 113
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3757
Mailing Address - Country:US
Mailing Address - Phone:919-977-5993
Mailing Address - Fax:
Practice Address - Street 1:3209 GRESHAM LAKE RD
Practice Address - Street 2:BUILDING 10, SUITE 113
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3757
Practice Address - Country:US
Practice Address - Phone:919-977-5993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-938261QM0850X
261QM2800X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder