Provider Demographics
NPI:1447481510
Name:CARE FIRST MENTAL HEALTH, PA
Entity type:Organization
Organization Name:CARE FIRST MENTAL HEALTH, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:252-628-8300
Mailing Address - Street 1:PO BOX 30365
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27833-0365
Mailing Address - Country:US
Mailing Address - Phone:252-628-8300
Mailing Address - Fax:252-642-6622
Practice Address - Street 1:114 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3728
Practice Address - Country:US
Practice Address - Phone:252-628-8300
Practice Address - Fax:252-642-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC290642084P0800X
NC0010-00147363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty