Provider Demographics
NPI:1598824302
Name:S&M GROUP SERVICES OF PITT COUNTY, LLC
Entity Type:Organization
Organization Name:S&M GROUP SERVICES OF PITT COUNTY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYMESHIE
Authorized Official - Middle Name:JEMEL
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-830-2100
Mailing Address - Street 1:1206 SOUTH EVANS ST.
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4102
Mailing Address - Country:US
Mailing Address - Phone:252-830-2100
Mailing Address - Fax:252-830-2101
Practice Address - Street 1:1206 SOUTH EVANS ST.
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4102
Practice Address - Country:US
Practice Address - Phone:252-830-2100
Practice Address - Fax:252-830-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-074-171322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children