Organization
COMMUNITY INNOVATIONS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BENSON (REVENUE CYCLE DIRECTOR)
(336) 553-5946
Entity
Organization
Contact information
Practice address
483 S CREEK RD, ORRUM, NC 28369-9269
(910) 738-1967
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3220
(919) 256-0824
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL078069
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340609H
—
NC
Enumeration date
11/01/2006
Last updated
09/12/2023
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