| NPI | 1952726614 |
|---|---|
| Former Legal Business Name | PORT HUMAN SERVICES |
| Entity Type | Organization |
| Authorized Contact | BRETT BEAVERS Credentialing Manager 919-210-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2023-05-24 |