Provider Demographics
NPI:1780810432
Name:CLIENTFIRST OF NC, LLC
Entity type:Organization
Organization Name:CLIENTFIRST OF NC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E ('KIP')
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-330-4367
Mailing Address - Street 1:1503 WAYNE MEMORIAL DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2203
Mailing Address - Country:US
Mailing Address - Phone:919-330-4367
Mailing Address - Fax:919-330-4375
Practice Address - Street 1:1503 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE H
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2203
Practice Address - Country:US
Practice Address - Phone:919-330-4367
Practice Address - Fax:919-330-4375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302577BMedicaid