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Organization
SOUTHLIGHT HEALTHCARE
Active
Organization
SOUTHLIGHT HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM HARTZELL (CEO)
(919) 787-6131
Entity
Organization
Contact information
Practice address
1952 SPRING DR, GARNER, NC 27529-3486
(919) 557-6967
(919) 557-6871
Mailing address
3125 POPLARWOOD COURT, SUITE 203, RALEIGH, NC 27604-6445
(919) 787-6131
(919) 571-2932
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
MHL092461
NC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2800X
Methadone Clinic
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300978
—
NC
Enumeration date
06/26/2007
Last updated
12/13/2022
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