Provider Demographics
NPI:1700219334
Name:COLONIAL INTEGRATIVE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:COLONIAL INTEGRATIVE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-312-0127
Mailing Address - Street 1:2820 PEACHLEAF ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-7966
Mailing Address - Country:US
Mailing Address - Phone:888-312-0127
Mailing Address - Fax:888-312-0127
Practice Address - Street 1:2849 NEW BERN AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:888-312-0127
Practice Address - Fax:888-312-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty