Provider Demographics
NPI:1922273960
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:COMMUNITY HOUSE II-DURHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE ASST
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:L
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:27607-5166
Mailing Address - Country:US
Mailing Address - Phone:919-981-0740
Mailing Address - Fax:
Practice Address - Street 1:409 EBON RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1621
Practice Address - Country:US
Practice Address - Phone:919-544-8961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-032-437320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness