# PRIDE IN NORTH CAROLINA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pride In North Carolina, Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770621526
- **Authorized official:** MR. JASON RUTSKI (DIRECTOR OF BUSINESS OPERATIONS)
- **Authorized official phone:** (910) 452-1460

## Contact information

- **Practice address:** 2815 S CHURCH ST STE 100, BURLINGTON, NC 27215-5105
- **Practice address phone:** (336) 586-0647
- **Practice address fax:** (336) 586-0729
- **Mailing address:** 231 COMMERCE ST, GREENVILLE, NC 27858-5029
- **Mailing address phone:** (252) 321-8080
- **Mailing address fax:** (252) 321-7999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 10/04/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8300581 | — | NC |
| 05 | — | 8300581B | — | NC |
| 05 | — | 8300581G | — | NC |