Provider Demographics
NPI:1871904540
Name:PEOPLE HELPING PEOPLE OF NORTH CAROLINA LLC
Entity type:Organization
Organization Name:PEOPLE HELPING PEOPLE OF NORTH CAROLINA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-760-1330
Mailing Address - Street 1:1510 MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4906
Mailing Address - Country:US
Mailing Address - Phone:336-760-1330
Mailing Address - Fax:336-760-1341
Practice Address - Street 1:1100 W. 1ST ST.
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3612
Practice Address - Country:US
Practice Address - Phone:336-724-9768
Practice Address - Fax:336-722-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-034-275251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300090SMedicaid