Doctor Name: | THOMAS MCCOLLUM |
NPI Number: | 1972633691 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 202 Hart St Snow Hill, NC - 285801704 |
Business Phone Number: | 2527477824 |
Business Fax Number: | |
Mailing Address: | Po Box 295, SNOW HILL |
State: | NC |
Postal Code: | 285800295 |
Phone Number: | 2527474000 |
Fax Number: | 2527472602 |
NPI Enumeration Date: | 03/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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. |