Provider Demographics
NPI:1013082312
Name:SANDHILLS CHILDRENS CENTER
Entity Type:Organization
Organization Name:SANDHILLS CHILDRENS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:GAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:910-692-3323
Mailing Address - Street 1:1280 CENTRAL DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2102
Mailing Address - Country:US
Mailing Address - Phone:910-692-3323
Mailing Address - Fax:910-692-1114
Practice Address - Street 1:1280 CENTRAL DR
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2102
Practice Address - Country:US
Practice Address - Phone:910-692-3323
Practice Address - Fax:910-692-2096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6355087261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300012KMedicaid
NC8300012Medicaid