Provider Demographics
NPI:1407052194
Name:QUALITY CARE BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:QUALITY CARE BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-330-6667
Mailing Address - Street 1:PO BOX 942
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28555-0942
Mailing Address - Country:US
Mailing Address - Phone:910-330-6667
Mailing Address - Fax:
Practice Address - Street 1:402 MAPLE STREET
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28555-0942
Practice Address - Country:US
Practice Address - Phone:910-330-6667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-052-002320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities