| NPI | 1497075618 |
|---|---|
| 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 |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2023-05-24 |