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
410 PEANUT PLANT RD, ELIZABETHTOWN, NC 28337-9482
(910) 862-8363
(910) 862-8767
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3215
(919) 256-0824
(919) 256-0833
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300962
—
NC
05
—
8300962B
—
NC
05
—
8300962G
—
NC
05
—
8300962H
—
NC
Enumeration date
05/16/2007
Last updated
04/28/2009
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