Provider Demographics
NPI:1316129612
Name:EASTERN COUNTY COMMUNITY HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:EASTERN COUNTY COMMUNITY HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERANDA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-908-0313
Mailing Address - Street 1:P.O. BOX 2581
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802
Mailing Address - Country:US
Mailing Address - Phone:252-908-0313
Mailing Address - Fax:252-937-7157
Practice Address - Street 1:120 N. FRANKLIN STREET UNIT I, SUITE 100
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804
Practice Address - Country:US
Practice Address - Phone:252-908-0313
Practice Address - Fax:252-937-7157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral Health