Provider Demographics
NPI:1366656464
Name:COUNTY OF HALIFAX
Entity Type:Organization
Organization Name:COUNTY OF HALIFAX
Other - Org Name:HALIFAX COUNTY DSS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:EXUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-678-3964
Mailing Address - Street 1:4421 HIGHWAY 301
Mailing Address - Street 2:POST OFFICE BOX 767
Mailing Address - City:HALIFAX
Mailing Address - State:NC
Mailing Address - Zip Code:27839
Mailing Address - Country:US
Mailing Address - Phone:252-536-2511
Mailing Address - Fax:252-536-2432
Practice Address - Street 1:4421 HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:NC
Practice Address - Zip Code:27839
Practice Address - Country:US
Practice Address - Phone:252-536-2511
Practice Address - Fax:252-536-2432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2024-04-04
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2013-03-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408154Medicaid
NC8700060Medicaid