Provider Demographics
NPI:1932365178
Name:STANDARDS-BASED SOLUTIONS NC BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:STANDARDS-BASED SOLUTIONS NC BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:SHAW
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MSW
Authorized Official - Phone:919-672-4472
Mailing Address - Street 1:510 MEADOWMONT VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7584
Mailing Address - Country:US
Mailing Address - Phone:919-967-5429
Mailing Address - Fax:
Practice Address - Street 1:19210 STONE BRK
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8349
Practice Address - Country:US
Practice Address - Phone:919-967-5429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency