Organization
PHYSICIAN ALLIANCE FOR MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RENE' KACZYNSKI (PROVIDER MANAGER)
(910) 262-7107
Entity
Organization
Contact information
Practice address
4130 OLEANDER DRIVE, SUITE 100, WILMINGTON, NC 28403-4423
(910) 794-3929
(910) 798-2303
Mailing address
4130 OLEANDER DRIVE, SUITE 100, WILMINGTON, NC 28403-4423
(910) 794-3929
(910) 798-2303
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8703155
—
NC
Enumeration date
01/24/2011
Last updated
01/24/2011
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