Organization
COMMUNITY INNOVATIONS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY ANDERSON (PRESIDENT)
(910) 739-8849
Entity
Organization
Contact information
Practice address
328 E 24TH ST, LUMBERTON, NC 28358-3102
(910) 737-6440
(910) 737-6499
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3215
(919) 256-0824
(919) 256-8750
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL078270
NC
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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