Provider Demographics
NPI:1982724613
Name:GLB HEALTH AND ASSESSMENT SERVICES, INC.
Entity Type:Organization
Organization Name:GLB HEALTH AND ASSESSMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:LOCKLEAR
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-997-2620
Mailing Address - Street 1:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28380-0472
Mailing Address - Country:US
Mailing Address - Phone:910-997-2620
Mailing Address - Fax:910-997-2622
Practice Address - Street 1:393 W US HIGHWAY 74
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3397
Practice Address - Country:US
Practice Address - Phone:910-997-2620
Practice Address - Fax:910-997-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty