Provider Demographics
NPI:1659416105
Name:CENTERPOINT HUMAN SERVICES
Entity Type:Organization
Organization Name:CENTERPOINT HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUCHAMP
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:336-714-9130
Mailing Address - Street 1:4045 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3325
Mailing Address - Country:US
Mailing Address - Phone:336-714-9100
Mailing Address - Fax:336-714-9310
Practice Address - Street 1:4045 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3325
Practice Address - Country:US
Practice Address - Phone:336-714-9100
Practice Address - Fax:336-714-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408291Medicaid
NC3404917Medicaid