Basic Information
| Provider Information | |||||||||
| NPI: | 1184859761 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAROLINA COMMUNITY MENTAL HEALTH CENTERS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2030 W TILGHMAN ST | ||||||||
| Address2: | SUITE 105B | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181044354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4842219136 | ||||||||
| FaxNumber: | 4842219130 | ||||||||
| Practice Location | |||||||||
| Address1: | 4020 CAPITAL BLVD STE 102 | ||||||||
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| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276043474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198753211 | ||||||||
| FaxNumber: | 9198754122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2009 | ||||||||
| LastUpdateDate: | 05/26/2009 | ||||||||
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| AuthorizedOfficialLastName: | CHLEBOWSKI | ||||||||
| AuthorizedOfficialFirstName: | MELISSA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4842219136 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.