Organization
NORTH CAROLINA ELDERLY PSYCHIATRIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN B MANGANO (CHIEF OPERATING OFFICER)
(919) 443-2360
Entity
Organization
Contact information
Practice address
606 WADE AVE, RALEIGH, NC 27605-1390
(919) 443-2360
(919) 800-3039
Mailing address
606 WADE AVE, RALEIGH, NC 27605-1390
(919) 443-2360
(919) 800-3039
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/15/2012
Last updated
04/18/2012
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