Provider Demographics
NPI:1720276041
Name:REDIRECTIONS OF NC, LLC
Entity Type:Organization
Organization Name:REDIRECTIONS OF NC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-830-9992
Mailing Address - Street 1:300 E ARLINGTON BLVD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5037
Mailing Address - Country:US
Mailing Address - Phone:252-830-9992
Mailing Address - Fax:252-830-9995
Practice Address - Street 1:300 E ARLINGTON BLVD
Practice Address - Street 2:SUITE 2B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5037
Practice Address - Country:US
Practice Address - Phone:252-830-9992
Practice Address - Fax:252-830-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health