1811167208 NPI number — CARENET, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811167208 NPI number — CARENET, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARENET, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BAPTIST HOSPITAL CARENET COUNSELING CENTERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811167208
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
805 WESTMONT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28305-4555
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-484-4061
Provider Business Mailing Address Fax Number:
910-485-4069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
805 WESTMONT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28305-4555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-484-4061
Provider Business Practice Location Address Fax Number:
910-485-4069
Provider Enumeration Date:
03/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SCOGGIN
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
N.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
336-716-7578

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6103661 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6002808 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6103781 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6111965 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6006368 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6000425 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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