Provider Demographics
NPI:1659702793
Name:ENHANCEMENT HEALTH CARE , INC.
Entity Type:Organization
Organization Name:ENHANCEMENT HEALTH CARE , INC.
Other - Org Name:STAR HEALTH SERVICES (SPRING HILL )
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-479-6600
Mailing Address - Street 1:600 AUDUBON LAKE DR
Mailing Address - Street 2:APT. 1A11
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8530
Mailing Address - Country:US
Mailing Address - Phone:919-479-6600
Mailing Address - Fax:919-479-1010
Practice Address - Street 1:600 AUDUBON LAKE DR
Practice Address - Street 2:APT. 1A11
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8530
Practice Address - Country:US
Practice Address - Phone:919-479-6600
Practice Address - Fax:919-479-1010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENHANCEMENT HEALTH CARE , INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-032-589261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418634Medicaid
NC7805437Medicaid
NC1205268109OtherNPI