# PORT HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PORT Human Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245500909
- **Authorized official:** BRETT BEAVERS (CREDENTIALING MANAGER)
- **Authorized official phone:** (919) 210-7661

## Contact information

- **Practice address:** 2808 S CROATAN HWY STE B, NAGS HEAD, NC 27959-9024
- **Practice address phone:** (252) 441-2324
- **Practice address fax:** (252) 441-1994
- **Mailing address:** 4300 SAPPHIRE CT STE 110, GREENVILLE, NC 27834-9079
- **Mailing address phone:** (252) 830-7540
- **Mailing address fax:** (252) 413-0932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | MHL-028-018 | NC | Yes |

## Other

- **Enumeration date:** 01/11/2012
- **Last updated:** 05/15/2023