Provider Demographics
NPI:1679807051
Name:CLINICAL ASSOCIATES HEALTHCARE
Entity type:Organization
Organization Name:CLINICAL ASSOCIATES HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-395-1322
Mailing Address - Street 1:5854 FARINGDON PL
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3931
Mailing Address - Country:US
Mailing Address - Phone:919-395-1322
Mailing Address - Fax:
Practice Address - Street 1:5854 FARINGDON PLACE
Practice Address - Street 2:SUITE 2
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:919-395-1322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC112596251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health