CREECH ROAD SUPERVISED GARE NPI 1689918641

NPI Information

NPI: 1689918641
Provider Name: CREECH ROAD SUPERVISED GARE

Doing Business As: EZEKIEL WILSON

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
311 NEW BERN AVE
# 27991
RALEIGH, NC
ZIP 27611
Phone: (919) 961-1392
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CREECH ROAD SUPERVISED GARE is a mental health counselor in Raleigh, NC. CREECH ROAD SUPERVISED GARE NPI is 1689918641. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ezekiel Wilson.

The provider's business location address is:

311 NEW BERN AVE
# 27991
RALEIGH, NC
ZIP 27611-801
Phone: (919) 961-1392

The provider's authorized official is Ezekiel Wilson .
The authorized official title is Owner and has the following contact phone number (919) 961-1392.

The enumeration date for this NPI number is 11/15/2012 and was last updated on 11/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	MHL 092761	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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