Provider Demographics
NPI:1962528232
Name:NECCO
Entity type:Organization
Organization Name:NECCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE ATTORNEY
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODENOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:740-894-7180
Mailing Address - Street 1:6015 FAYETTEVILLE RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6254
Mailing Address - Country:US
Mailing Address - Phone:919-323-8081
Mailing Address - Fax:919-572-0004
Practice Address - Street 1:2001 FORD CIR
Practice Address - Street 2:SUITE A
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-3702
Practice Address - Country:US
Practice Address - Phone:513-248-9705
Practice Address - Fax:513-248-9702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health