Provider Demographics
NPI:1326122276
Name:OXBRIDGE EDUCATORS, INC
Entity Type:Organization
Organization Name:OXBRIDGE EDUCATORS, INC
Other - Org Name:PUZZLE PIECE PROGRAMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:LORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-870-7780
Mailing Address - Street 1:5510 MUNFORD RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2621
Mailing Address - Country:US
Mailing Address - Phone:919-870-7780
Mailing Address - Fax:919-600-6700
Practice Address - Street 1:5510 MUNFORD RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2621
Practice Address - Country:US
Practice Address - Phone:919-870-7780
Practice Address - Fax:919-882-9933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 1041C0700X, 106H00000X
NCMHL092625261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8464OtherLME PROVIDER CODE
NC6008071Medicaid
NC8301492RMedicaid
NC6503OtherLME PROGRAM CODE
NC8301492HMedicaid