Organization
DIXON SOCIAL INTERACTIVE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DERRIA NOLEN DIXON (CFO)
(252) 258-8946
Entity
Organization
Contact information
Practice address
113 W FIRETOWER RD STE A, WINTERVILLE, NC 28590-8414
(252) 353-0100
(252) 353-0600
Mailing address
2105 KING LEAR CT, GREENVILLE, NC 27858-8504
(252) 258-8946
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005438
—
NC
05
—
8300652
—
NC
Enumeration date
03/30/2007
Last updated
08/22/2020
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