PORT HEALTH SERVICES NPI 1154473239

NPI Information

  • NPI: 1154473239
  • Provider Name: PORT HEALTH SERVICES
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • Former Legal Business Name: PORT HUMAN SERVICES
  • Address: 144 COMMUNITY COLLEGE RD STE C
    AHOSKIE, NC
    ZIP 27910
  • Phone: (252) 332-5086

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NPI Details

PORT HEALTH SERVICES is a substance abuse rehabilitation facility in Ahoskie, NC. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. PORT HEALTH SERVICES NPI is 1154473239. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Port Human Services.

The provider's business location address is:

144 COMMUNITY COLLEGE RD STE C
AHOSKIE, NC
ZIP 27910-047
Phone: (252) 332-5086
Fax: (252) 332-5243

The provider's authorized official is Brett Beavers .
The authorized official title is Credentialing Manager and has the following contact phone number (919) 210-7661.

The enumeration date for this NPI number is 1/17/2007 and was last updated on 5/15/2023.

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
1251S00000XCommunity/Behavioral HealthNo
2324500000XSubstance Abuse Rehabilitation FacilityMHL-046-015NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18301162MEDICAIDNORTH CAROLINA

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: 3/30/2025

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