Organization
CAROLINA BEHAVIORAL SUPPORT SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISRAEL OJIMADU (CEO)
(919) 266-3591
Entity
Organization
Contact information
Practice address
7048 KNIGHTDALE BLVD, SUITE 101, KNIGHTDALE, NC 27545-8894
(919) 266-3591
(919) 266-3809
Mailing address
7048 KNIGHTDALE BLVD, SUITE 101, KNIGHTDALE, NC 27545-8894
(919) 266-3591
(919) 266-3809
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410221
—
NC
05
—
8303254
—
NC
Enumeration date
05/18/2012
Last updated
05/18/2012
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