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Organization

COMMUNITY INNOVATIONS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY JOHNS BENSON (REVENUE CYCLE DIRECTOR)
(704) 995-2131
Entity
Organization

Contact information

Practice address
68 MITCHELL FORD ROAD, CLARKTON, NC 28433
(910) 647-2801
Mailing address
4000 PARAMOUNT PKWY STE 100, MORRISVILLE, NC 27560-8484
(704) 995-2131

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL009009
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340601X
NC
Enumeration date
11/01/2006
Last updated
04/19/2023
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