Provider Demographics
NPI:1730310533
Name:ADVANCE BEHAVIORAL CENTER, INC.
Entity Type:Organization
Organization Name:ADVANCE BEHAVIORAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-527-8073
Mailing Address - Street 1:317 CHATHAM ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4801
Mailing Address - Country:US
Mailing Address - Phone:919-777-0212
Mailing Address - Fax:910-778-7279
Practice Address - Street 1:317 CHATHAM ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4801
Practice Address - Country:US
Practice Address - Phone:919-777-0212
Practice Address - Fax:910-778-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health