Provider Demographics
NPI:1285839571
Name:BORDERBELT AIDS RESOURCES TEAM, INC.
Entity Type:Organization
Organization Name:BORDERBELT AIDS RESOURCES TEAM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-739-6167
Mailing Address - Street 1:3147 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-6915
Mailing Address - Country:US
Mailing Address - Phone:910-739-6167
Mailing Address - Fax:910-739-6169
Practice Address - Street 1:3147 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-6915
Practice Address - Country:US
Practice Address - Phone:910-739-6167
Practice Address - Fax:910-739-6169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700285Medicaid