Provider Demographics
NPI:1891837829
Name:THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.
Entity Type:Organization
Organization Name:THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.
Other - Org Name:LEE HARNETT ACTT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-981-0740
Mailing Address - Street 1:1331 SUNDAY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607
Mailing Address - Country:US
Mailing Address - Phone:919-981-0740
Mailing Address - Fax:919-954-7238
Practice Address - Street 1:150 PINE STATE ST
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-9414
Practice Address - Country:US
Practice Address - Phone:910-814-3599
Practice Address - Fax:910-814-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300429AMedicaid