Provider Demographics
NPI:1316568157
Name:BRYANT CRISIS INTERVENTION CENTER
Entity Type:Organization
Organization Name:BRYANT CRISIS INTERVENTION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHENAIL BRYANT
Authorized Official - Middle Name:LIIATT
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:MAS
Authorized Official - Phone:570-982-9900
Mailing Address - Street 1:PO BOX 348
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27846-0348
Mailing Address - Country:US
Mailing Address - Phone:570-982-9900
Mailing Address - Fax:
Practice Address - Street 1:1149 STEWART STREET
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NC
Practice Address - Zip Code:27846
Practice Address - Country:US
Practice Address - Phone:570-982-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty