Provider Demographics
NPI:1437300209
Name:SPECIAL CARE BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:SPECIAL CARE BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTIAL/ CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:CHAMBERS
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-937-5788
Mailing Address - Street 1:100 COASTLINE ST STE 314
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-5849
Mailing Address - Country:US
Mailing Address - Phone:252-937-5788
Mailing Address - Fax:
Practice Address - Street 1:100 COASTLINE ST STE 314
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-5849
Practice Address - Country:US
Practice Address - Phone:252-937-5788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization