Provider Demographics
NPI:1306147228
Name:INFINITE POSSIBILITIES, INC
Entity type:Organization
Organization Name:INFINITE POSSIBILITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KANIKA
Authorized Official - Middle Name:NASHON
Authorized Official - Last Name:TURRENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:252-431-1926
Mailing Address - Street 1:PO BOX 3042
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-6042
Mailing Address - Country:US
Mailing Address - Phone:252-431-1926
Mailing Address - Fax:252-431-1924
Practice Address - Street 1:425 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4201
Practice Address - Country:US
Practice Address - Phone:252-431-1926
Practice Address - Fax:252-431-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3419123Medicaid