Provider Demographics
NPI:1225174212
Name:ORANGE PERSON CHATHAM MH-DD-SA AUTHORITY
Entity Type:Organization
Organization Name:ORANGE PERSON CHATHAM MH-DD-SA AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:JENNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-913-4016
Mailing Address - Street 1:100 EUROPA DR
Mailing Address - Street 2:SUITE 490
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-2357
Mailing Address - Country:US
Mailing Address - Phone:919-913-4000
Mailing Address - Fax:919-913-4001
Practice Address - Street 1:100 EUROPA DR
Practice Address - Street 2:SUITE 490
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2357
Practice Address - Country:US
Practice Address - Phone:919-913-4000
Practice Address - Fax:919-913-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3404921EMedicaid
NC6005654Medicaid
NC3408137Medicaid
NC3404921Medicaid