1255768099 NPI number — STANDARDS-BASED SOLUTIONS BEHAVIORAL HEALTH CONSULTING & MANAGEMENT

Table of content: (NPI 1255768099)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255768099 NPI number — STANDARDS-BASED SOLUTIONS BEHAVIORAL HEALTH CONSULTING & MANAGEMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STANDARDS-BASED SOLUTIONS BEHAVIORAL HEALTH CONSULTING & MANAGEMENT
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:
Provider Other Organization Name Type Code:
6
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:
1255768099
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20082 LONG
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27517-7339
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-951-8919
Provider Business Mailing Address Fax Number:
919-967-9965

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3708 LYCKAN PKWY
Provider Second Line Business Practice Location Address:
201
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27707-2586
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-951-8919
Provider Business Practice Location Address Fax Number:
919-967-9965
Provider Enumeration Date:
10/10/2013

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
MILDRED
Authorized Official Middle Name:
SHAW
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
919-951-8919

Provider Taxonomy Codes

  • Taxonomy code: 103TM1800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com