Provider Demographics
NPI: | 1255771119 |
---|---|
Name: | NEIGHBORHEALTH CENTER, INC. |
Entity type: | Organization |
Organization Name: | NEIGHBORHEALTH CENTER, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | INTERIM CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LARRY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CHEWNING |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 984-222-8000 |
Mailing Address - Street 1: | 4201 LAKE BOONE TRL STE 5 |
Mailing Address - Street 2: | |
Mailing Address - City: | RALEIGH |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27607-7511 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4201 LAKE BOONE TRL STE 5 |
Practice Address - Street 2: | |
Practice Address - City: | RALEIGH |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27607-7511 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-332-7467 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-06-25 |
Last Update Date: | 2021-08-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |