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Organization

IMPERATIVE CHANGES OUTREACH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ANDRE GAY (EXECUTIVE DIRECTOR)
(252) 367-1112
Entity
Organization

Contact information

Practice address
1710 W THIRD ST, GREENVILLE, NC 27834-1669
(252) 367-1112
Mailing address
PO BOX 553, GREENVILLE, NC 27835-0553

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
12/02/2013
Last updated
12/02/2013
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