Organization Name: | HARVEST CARE OF NORTH CAROLINA, LLC |
NPI Number: | 1407003767 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHANDRA REVIS PEGUES (DIRECTOR & CEO) |
Mailing Address: | 503 Thurston Dr W Wilson |
State: | NC US |
Postal Code: | 278932858 |
Phone Number: | 2522815278 |
Fax Number: | |
NPI Enumeration Date: | 08/19/2008 |
NPI Last Update Date: | 08/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | MHL-098-122 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |