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Organization
PHYSICIAN ALLIANCE FOR MENTAL HEALTH LLC
Active
Organization
PHYSICIAN ALLIANCE FOR MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RENE' KACZYNSKI (PROVIDER MANAGER)
(910) 262-7107
Entity
Organization
Contact information
Practice address
3208 OLEANDER DR, WILMINGTON, NC 28403-0800
(910) 794-3929
(910) 798-2303
Mailing address
PO BOX 15511, WILMINGTON, NC 28408-5511
(910) 794-3929
(910) 798-2303
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410154
—
NC
Enumeration date
01/24/2011
Last updated
04/10/2014
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