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Organization
PARADISE LANDING 1
Active
Organization
PARADISE LANDING 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIDRE TABORN (EXECUTIVE DIRECTOR)
(252) 572-4262
Entity
Organization
Contact information
Practice address
1533 BRIGGS RD, HENDERSON, NC 27537-3898
(252) 572-4262
Mailing address
1533 BRIGGS RD, HENDERSON, NC 27537-3898
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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