Provider Demographics
NPI:1407032048
Name:TOTAL TURNAROUND MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:TOTAL TURNAROUND MENTAL HEALTH SERVICES, LLC
Other - Org Name:TOTAL TURNAROUND
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOJCIECHOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-799-0800
Mailing Address - Street 1:PO BOX 8592
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-8592
Mailing Address - Country:US
Mailing Address - Phone:252-799-0800
Mailing Address - Fax:252-799-0801
Practice Address - Street 1:827 EAST BOULEVARD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2772
Practice Address - Country:US
Practice Address - Phone:252-799-0800
Practice Address - Fax:252-799-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302277Medicaid
NC8302277HMedicaid
NC8302277GMedicaid
NC8302277RMedicaid