Organization
IDALIA COMMUNITY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL HOFFMAN (ADMINSTRATOR)
(919) 777-5300
Entity
Organization
Contact information
Practice address
111 LAMON ST, FAYETTEVILLE, NC 28301-4901
(919) 777-5300
Mailing address
111 LAMON ST, FAYETTEVILLE, NC 28301-4901
(919) 777-5300
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
11111
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11111111
—
NC
Enumeration date
07/19/2009
Last updated
07/19/2009
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