Provider Demographics
NPI:1689900235
Name:UMOJA BEHAVIORAL HEALTH CARE, LLC
Entity Type:Organization
Organization Name:UMOJA BEHAVIORAL HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LILLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-605-8608
Mailing Address - Street 1:2120 SPRINGS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-2198
Mailing Address - Country:US
Mailing Address - Phone:704-605-8608
Mailing Address - Fax:704-820-6506
Practice Address - Street 1:2120 SPRINGS ST
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-2198
Practice Address - Country:US
Practice Address - Phone:704-605-8608
Practice Address - Fax:704-820-6506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health