Provider Demographics
NPI:1366682593
Name:MISSIONS UNLIMITED, LLC
Entity Type:Organization
Organization Name:MISSIONS UNLIMITED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CEDRINA
Authorized Official - Middle Name:BELETHA
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, QP
Authorized Official - Phone:910-616-6979
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:COUNCIL
Mailing Address - State:NC
Mailing Address - Zip Code:28434-0151
Mailing Address - Country:US
Mailing Address - Phone:910-862-6264
Mailing Address - Fax:910-862-6268
Practice Address - Street 1:2950 W BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-7137
Practice Address - Country:US
Practice Address - Phone:910-862-6264
Practice Address - Fax:910-862-6268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-009-030251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health