Organization
COMMUNITY INNOVATIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD E JONES JR. (SR. VICE PRESIDENT)
(919) 256-0824
Entity
Organization
Contact information
Practice address
2003 GODWIN AVE, SUITE A, LUMBERTON, NC 28358-3197
(910) 739-8849
(910) 739-5167
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3215
(919) 256-0824
(919) 256-0833
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300964
—
NC
05
—
8300964B
—
NC
05
—
8300964G
—
NC
05
—
8300964H
—
NC
05
—
8300964S
—
NC
05
—
8300964V
—
NC
Enumeration date
05/17/2007
Last updated
08/03/2010
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