Provider Demographics
NPI:1710185996
Name:ANSON COUNTY COMMUNITY HEALTH SERVICES,LLC
Entity Type:Organization
Organization Name:ANSON COUNTY COMMUNITY HEALTH SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHOINECE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MHS
Authorized Official - Phone:704-694-9470
Mailing Address - Street 1:123 E MARTIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-2216
Mailing Address - Country:US
Mailing Address - Phone:704-694-9470
Mailing Address - Fax:704-694-2734
Practice Address - Street 1:123 E MARTIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2216
Practice Address - Country:US
Practice Address - Phone:704-694-9470
Practice Address - Fax:704-694-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health