Provider Demographics
NPI:1134402464
Name:TRUTH MENTAL HEALTH SUBSTANCE
Entity type:Organization
Organization Name:TRUTH MENTAL HEALTH SUBSTANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALBERTA
Authorized Official - Middle Name:LEVONE
Authorized Official - Last Name:MORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-257-2559
Mailing Address - Street 1:120 W EDINBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-2859
Mailing Address - Country:US
Mailing Address - Phone:910-848-1330
Mailing Address - Fax:910-848-2996
Practice Address - Street 1:120 W EDINBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-2859
Practice Address - Country:US
Practice Address - Phone:910-848-1330
Practice Address - Fax:910-848-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility