Provider Demographics
NPI:1285867804
Name:SKILLS MANAGEMENT GROUP, INC
Entity Type:Organization
Organization Name:SKILLS MANAGEMENT GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:W
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIDDICK
Authorized Official - Suffix:II
Authorized Official - Credentials:MED
Authorized Official - Phone:919-833-8247
Mailing Address - Street 1:2204 EVERS DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-4914
Mailing Address - Country:US
Mailing Address - Phone:919-833-8247
Mailing Address - Fax:
Practice Address - Street 1:2204 EVERS DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-4914
Practice Address - Country:US
Practice Address - Phone:919-833-8247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty