Organization
POSITIVE GENERATION IN CHRIST, INCORPORATED
Active
Other names
PGIC Inc
Organization subpart
No
Provider details
NPI number
Authorized official
IMMACULA SAINT LOUIS MD (MEDICAL DIRECTOR)
(667) 401-5936
Entity
Organization
Contact information
Practice address
109 BEACON RD, BALTIMORE, MD 21220-3504
(252) 813-2530
(252) 641-5461
Mailing address
PO BOX 1634, TARBORO, NC 27886-1634
(252) 641-4522
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251SOOOOOX
—
NC
Enumeration date
08/16/2019
Last updated
06/07/2022
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