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Organization
C-BLAC SERVICES, INC.
Active
Organization
C-BLAC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANET M WISE MSW, CSAC, LCAS (CEO)
(919) 989-1786
Entity
Organization
Contact information
Practice address
1302 W MARKET ST, SMITHFIELD, NC 27577-3339
(919) 989-1786
(919) 989-1791
Mailing address
PO BOX 1629, SMITHFIELD, NC 27577-1629
(919) 989-1786
(919) 989-1791
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MHL 051-128
NC
101YM0800X
Mental Health Counselor
MHL 051-128
NC
2084P0802X
Addiction Psychiatry Physician
MHL 051-128
NC
251B00000X
Case Management Agency
MHL 051-128
NC
251E00000X
Home Health Agency
MHL 051-128
NC
251K00000X
Public Health or Welfare Agency
MHL 051-128
NC
251S00000X
Community/Behavioral Health Agency
MHL 051-128
NC
261QM1300X
Multi-Specialty Clinic/Center
MHL 051-128
NC
Other
Enumeration date
10/16/2006
Last updated
05/20/2008
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