Provider Demographics
NPI:1609009547
Name:CAROLINA BEHAVIORAL AND THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:CAROLINA BEHAVIORAL AND THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:MARGUERITE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-619-6229
Mailing Address - Street 1:205 N WATER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4417
Mailing Address - Country:US
Mailing Address - Phone:252-619-6229
Mailing Address - Fax:
Practice Address - Street 1:205 N WATER ST
Practice Address - Street 2:SUITE A
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4417
Practice Address - Country:US
Practice Address - Phone:252-619-6229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health