Organization
DIRECCARE BEHAVIORAL SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERECK COE (CO-OWNER)
(910) 872-0013
Entity
Organization
Contact information
Practice address
129 WEST BROAD ST., SUITE C, ELIZABETHTOWN, NC 28337-9005
(910) 872-0013
(910) 872-0019
Mailing address
63 PRIDGEN RD, LUMBERTON, NC 28358-9726
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301855B
—
NC
05
—
8301855G
—
NC
05
—
8301855H
—
NC
Enumeration date
09/12/2007
Last updated
09/12/2007
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