Provider Demographics
NPI:1922328822
Name:CAROLINA BEHAVIORAL CARE
Entity Type:Organization
Organization Name:CAROLINA BEHAVIORAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLEURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-295-6007
Mailing Address - Street 1:220 SMITH CHURCH RD
Mailing Address - Street 2:BUILDING C
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4914
Mailing Address - Country:US
Mailing Address - Phone:252-537-6619
Mailing Address - Fax:252-537-1540
Practice Address - Street 1:220 SMITH CHURCH RD
Practice Address - Street 2:BUILDING C
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4914
Practice Address - Country:US
Practice Address - Phone:252-537-6619
Practice Address - Fax:252-537-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty