Provider Demographics
NPI:1154516367
Name:ZOE BEHAVIOR HEALTH SERVICES
Entity type:Organization
Organization Name:ZOE BEHAVIOR HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:BURRELL
Authorized Official - Last Name:WITHERSPOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-785-0861
Mailing Address - Street 1:974 WOODLEAF CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-1563
Mailing Address - Country:US
Mailing Address - Phone:336-785-0861
Mailing Address - Fax:336-771-2676
Practice Address - Street 1:974 WOODLEAF CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-1563
Practice Address - Country:US
Practice Address - Phone:336-785-0861
Practice Address - Fax:336-771-2676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301848BMedicaid
NC8301848Medicaid