Organization
SOUTH SHORE MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONIA GOODEN-ALEXIS (SELF)
(919) 323-0381
Entity
Organization
Contact information
Practice address
4820 SWANNS MILL DR, DURHAM, NC 27704-1492
(919) 323-0381
Mailing address
4820 SWANNS MILL DR, DURHAM, NC 27704-1492
(919) 323-0381
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
5736
MA
251K00000X
Public Health or Welfare Agency
Primary
6748
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S014759
—
MA
Enumeration date
10/11/2006
Last updated
11/17/2008
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