Organization
THERAPEUTIC BEHAVIORAL HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLE E. SPRUILL (CEO)
(910) 628-7755
Entity
Organization
Contact information
Practice address
302 N MAIN ST, FAIRMONT, NC 28340-1730
(910) 628-5655
(910) 628-7755
Mailing address
PO BOX 1664, FAIRMONT, NC 28340-1103
(910) 628-5655
(910) 628-7755
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4408
NC
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418946
—
NC
Enumeration date
01/15/2010
Last updated
07/18/2011
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