| NPI | 1477538254 |
|---|---|
| Former Legal Business Name | PORT HUMAN SERVICES |
| Entity Type | Organization |
| Authorized Contact | BRETT BEAVERS Credentialing Manager 919-210-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC MHL-074-157) |
| Additional Taxonomies | 251S00000X |
| 261QC1500X Clinic/Center, Community Health | |
| 291U00000X Clinical Medical Laboratory | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: NC MHL-074-145) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2023-05-24 |