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Organization
VIRGINIA DARE BEHAVORIAL HEALTH SERVICES INC.
Active
Organization
VIRGINIA DARE BEHAVORIAL HEALTH SERVICES INC.
Active
Other names
Virginia Dare Home C
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PHYLLIS MAXINE WARD (ADMINISTRATOR)
(252) 238-2622
Entity
Organization
Contact information
Practice address
367 LANE ROAD, STANTONSBURG, NC 27883
(252) 238-2622
(252) 238-6566
Mailing address
367 LANE ROAD, STANTONSBURG, NC 27883
(252) 238-2622
(252) 238-6566
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
MHL040016
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409231
—
NC
05
—
7805104
—
NC
05
—
8301320
—
NC
Enumeration date
03/19/2007
Last updated
08/22/2020
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