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Organization

HIGH 5 EARLY INTERVENTION SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TISHA NIKITA EVANS (CHIEF OPERATING OFFICER/DIRECTOR)
(910) 479-4141
Entity
Organization

Contact information

Practice address
156 RYE LN, RAEFORD, NC 28376-5301
(910) 479-4141
Mailing address
156 RYE LN, RAEFORD, NC 28376-5301
(910) 479-4141

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
02/27/2020
Last updated
02/29/2020
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