# COMMUNITY INNOVATIONS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164798518
- **Authorized official:** HAROLD ERNEST JONES JR. (SR. VICE PRESIDENT)
- **Authorized official phone:** (919) 256-0824

## Contact information

- **Practice address:** 3972 BUSINESS 17 E, STE C, BOLIVIA, NC 28422-9030
- **Practice address phone:** (910) 253-8700
- **Practice address fax:** (910) 253-8755
- **Mailing address:** 3210 FAIRHILL DR, RALEIGH, NC 27612-3215
- **Mailing address phone:** (919) 256-0824
- **Mailing address fax:** (919) 256-0833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/30/2012
- **Last updated:** 10/08/2012