Provider Demographics
NPI:1720163819
Name:COUNTY OF PERSON OFFICE OF COUNTY FINANCE
Entity Type:Organization
Organization Name:COUNTY OF PERSON OFFICE OF COUNTY FINANCE
Other - Org Name:PERSON INDUSTRIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-599-7571
Mailing Address - Street 1:304 SOUTH MORGAN STREET
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573
Mailing Address - Country:US
Mailing Address - Phone:336-599-7571
Mailing Address - Fax:336-597-2834
Practice Address - Street 1:601 NORTH MADISON BLVD
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573
Practice Address - Country:US
Practice Address - Phone:336-599-7571
Practice Address - Fax:336-597-2834
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF PERSON OFFICE OF COUNTY FINANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-26
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-073-049251C00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408652Medicaid
NC8300755Medicaid