Organization
SUCCESS DYNAMICS COMMUNITY DEVELOPMENT CORPORATION
Active
Other names
Oasis Community Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CALVIN O. ELLISON N.D., PHD (EXECUTIVE DIRECTOR)
(252) 753-7815
Entity
Organization
Contact information
Practice address
7227 STATONSBURG ROAD, FARMVILLE, NC 27828-0214
(252) 753-7815
(252) 753-8787
Mailing address
PO BOX 214, FARMVILLE, NC 27828-0214
(252) 753-7815
(252) 753-8787
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8700515
—
NC
Enumeration date
01/28/2008
Last updated
07/22/2008
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