Organization
HIGHLAND CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALVIN WILSON (CEO)
(910) 678-2088
Entity
Organization
Contact information
Practice address
823 ELM ST STE 207, FAYETTEVILLE, NC 28303-4164
(910) 678-2088
(910) 678-0915
Mailing address
823 ELM ST STE 207, FAYETTEVILLE, NC 28303-4164
(910) 678-2088
(910) 678-0915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
34418
NC
305S00000X
Point of Service
Primary
34418
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8961588
—
NC
Enumeration date
03/11/2009
Last updated
03/11/2009
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