Provider Demographics
NPI:1356543599
Name:SOUTHERN CROSS COMMUNITY SERVICES INC
Entity type:Organization
Organization Name:SOUTHERN CROSS COMMUNITY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCK
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:TAULBEE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:910-763-3773
Mailing Address - Street 1:112 PREMIERE PLZ
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-2522
Mailing Address - Country:US
Mailing Address - Phone:910-640-2007
Mailing Address - Fax:910-640-3911
Practice Address - Street 1:112 PREMIERE PLZ
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-2522
Practice Address - Country:US
Practice Address - Phone:910-640-2007
Practice Address - Fax:910-640-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health