Organization
COMMUNITY CARE CENTER IND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ESAU ARNOLD MCMORRIS QMHP (PRESIDENT)
(252) 208-1928
Entity
Organization
Contact information
Practice address
110 S QUEEN ST, SUITE 118, KINSTON, NC 28501-4973
(252) 208-1928
(252) 559-2055
Mailing address
110 S QUEEN ST, SUITE 118, KINSTON, NC 28501-4973
(252) 208-1928
(252) 559-2055
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251S00000X
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301433
—
NC
Enumeration date
03/22/2007
Last updated
08/22/2020
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