Provider Demographics
NPI:1295894202
Name:ONSLOW CARTERET BEHAVIORAL HEALTHCARE SERVICES
Entity type:Organization
Organization Name:ONSLOW CARTERET BEHAVIORAL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-219-8000
Mailing Address - Street 1:165 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5708
Mailing Address - Country:US
Mailing Address - Phone:910-219-8000
Mailing Address - Fax:910-353-4765
Practice Address - Street 1:215 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-353-5118
Practice Address - Fax:910-353-4765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-067-002251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901887OtherPHYSICIAN GROUP
NC8301604Medicaid
NC6005558OtherINDEP MH PRACTITIONER GRP
NC43021OtherSTATE ID
NC3404934Medicaid