Organization
C&A COMMUNITY INTERVENTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANGELA GAIL SOUTHERLAND (EXECUTIVE DIRECTOR/MEDICAL BILLER)
(910) 670-6567
Entity
Organization
Contact information
Practice address
219 BELMONT DR, RAEFORD, NC 28376-8014
(901) 670-6567
(910) 904-2931
Mailing address
219 BELMONT DR, RAEFORD, NC 28376-8014
(901) 670-6567
(910) 904-2931
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385HR2050X
Respite Care Camp
—
—
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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