Provider Demographics
NPI:1366549636
Name:NORTH, INC.
Entity type:Organization
Organization Name:NORTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-781-0661
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-0445
Mailing Address - Country:US
Mailing Address - Phone:910-944-8125
Mailing Address - Fax:910-944-3984
Practice Address - Street 1:4505 FAIR MEADOWS LN
Practice Address - Street 2:SUITE 203
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6465
Practice Address - Country:US
Practice Address - Phone:919-781-0661
Practice Address - Fax:919-881-6580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408784Medicaid
NC3418526Medicaid
NC6005619Medicaid