Organization
COMMUNITY INNOVATIONS,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDY ANDERSON (PRESIDENT)
(910) 739-8849
Entity
Organization
Contact information
Practice address
2209 CENTURY DR, SUITE 101, RALEIGH, NC 27612-3941
(919) 786-4944
(919) 786-4945
Mailing address
2003 GODWIN AVE, SUITE A, LUMBERTON, NC 28358-3197
(910) 739-8849
(910) 739-5167
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301839B
—
NC
Enumeration date
04/11/2007
Last updated
08/22/2020
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