Organization
FIDELITY FIRST HEALTH CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY JACOBS QP, BA (PROGRAM DIRECTOR)
(910) 343-1003
Entity
Organization
Contact information
Practice address
3825 MARKET ST, SUITE 6, WILMINGTON, NC 28403-1453
(910) 343-1003
Mailing address
3825 MARKET ST, SUITE 6, WILMINGTON, NC 28403-1453
(910) 343-1003
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251S00000X
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301726B
—
NC
Enumeration date
09/11/2007
Last updated
09/11/2007
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