Provider Demographics
NPI:1710148333
Name:THE MYCHAEL CENTER, LLC
Entity Type:Organization
Organization Name:THE MYCHAEL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DESIGNEE
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURNAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-227-8430
Mailing Address - Street 1:1714 GLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9680
Mailing Address - Country:US
Mailing Address - Phone:252-227-8430
Mailing Address - Fax:
Practice Address - Street 1:119B W 3RD ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-1807
Practice Address - Country:US
Practice Address - Phone:252-227-8430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health