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Organization

INNOVATIVE PROGRAMMING ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE COLEY (BILLING SPECIALIST)
(910) 483-0734
Entity
Organization

Contact information

Practice address
1023 HIGHWAY 17 SUITE 1, ELIZABETH CITY, NC 27909-9070
(910) 483-0734
Mailing address
111 LAMON ST STE 201, FAYETTEVILLE, NC 28301-4957

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
NC
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
NC
324500000X
Substance Abuse Rehabilitation Facility
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6005327
NC
Enumeration date
03/07/2007
Last updated
08/23/2007
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