Provider Demographics
NPI:1558782797
Name:MHS UNLIMITED,CORPORATION
Entity Type:Organization
Organization Name:MHS UNLIMITED,CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:H
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:336-322-0657
Mailing Address - Street 1:203 N MAIN ST
Mailing Address - Street 2:STE 216
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-5343
Mailing Address - Country:US
Mailing Address - Phone:336-322-0657
Mailing Address - Fax:336-322-0726
Practice Address - Street 1:203 N MAIN ST
Practice Address - Street 2:STE 216
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5343
Practice Address - Country:US
Practice Address - Phone:336-322-0657
Practice Address - Fax:336-322-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418565Medicaid