Organization
BENJAMIN HOUSE, INC.
Active
Other names
Community Intervention Services Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E GILBERT QP (CHIEF EXECUTIVE OFFICER)
(252) 331-7731
Entity
Organization
Contact information
Practice address
1221 CAROLINA AVE, SUITE 3, ELIZABETH CITY, NC 27909-5458
(252) 331-7731
(252) 331-1777
Mailing address
1221 CAROLINA AVE, SUITE 3, ELIZABETH CITY, NC 27909-5458
(252) 331-7731
(252) 331-1777
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
8300836
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300836
—
NC
Enumeration date
07/19/2007
Last updated
07/19/2007
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