Provider Demographics
NPI:1891936167
Name:EAST CAROLINA BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:EAST CAROLINA BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:HANSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BA/QP
Authorized Official - Phone:252-327-3524
Mailing Address - Street 1:4611 GRINDING STONE DR APT A
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-2713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 BROWNING LN
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-9058
Practice Address - Country:US
Practice Address - Phone:919-418-7062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services