Provider Demographics
NPI:1790667004
Name:PRIDE IN HILLSBOURGH
Entity type:Organization
Organization Name:PRIDE IN HILLSBOURGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEER SUPPORT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMEELAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-968-0635
Mailing Address - Street 1:432 PATRIOTS POINTE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-9021
Mailing Address - Country:US
Mailing Address - Phone:516-968-0635
Mailing Address - Fax:
Practice Address - Street 1:432 PATRIOTS POINTE DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-9021
Practice Address - Country:US
Practice Address - Phone:516-968-0635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty