Provider Demographics
NPI:1922402833
Name:NEW HANOVER COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:NEW HANOVER COMMUNITY HEALTH CENTER
Other - Org Name:MEDNORTH HEALTH CENTER INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-202-8613
Mailing Address - Street 1:925 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-3450
Mailing Address - Country:US
Mailing Address - Phone:910-202-8613
Mailing Address - Fax:
Practice Address - Street 1:925 N 4TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3450
Practice Address - Country:US
Practice Address - Phone:910-202-8613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty