Provider Demographics
NPI:1124886965
Name:CENTENNIAL HOUSING & COMMUNITY SERVICES CORPORATION
Entity type:Organization
Organization Name:CENTENNIAL HOUSING & COMMUNITY SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:TITUS
Authorized Official - Last Name:AVIGNONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-629-7860
Mailing Address - Street 1:958 US HIGHWAY 64 E
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-9216
Mailing Address - Country:US
Mailing Address - Phone:252-795-4135
Mailing Address - Fax:
Practice Address - Street 1:104 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2156
Practice Address - Country:US
Practice Address - Phone:217-519-9654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty