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East Carolina University Horizons

Organization Active NPI Community/Behavioral Health Agency · Greenville, NC

NPI 1750433728 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1750433728
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
MHL074127 (NC)
Legal business name
EAST CAROLINA UNIVERSITY HORIZONS
Practice address
174 Minges Coliseum Ecu RCLS Dept.
Greenville, NC 27858-4353
Phone
(252) 328-4640
Fax
(252) 328-4642
NPI assigned
Jan 18, 2007
Organization subpart
No

Authorized official

Name
Dr. Thomas K. Skalko, PH.D.
Title
Director
Phone
(252) 328-0018

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
East Carolina University Student Health Service (65 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL074127 NC Yes

Addresses

Primary practice location

174 Minges Coliseum Ecu RCLS Dept.
Greenville, NC 27858-4353

Mailing address

Belk Annex 4
Ecu RCLS Department-Ecu Horizons
Greenville, NC 27858-4353
Phone (252) 328-4640

Other identifiers

IdentifierTypeStateIssuer
8301318MedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750433728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BELK ANNEX 4",
            "address_2": "ECU RCLS DEPARTMENT-ECU HORIZONS",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278584353",
            "telephone_number": "252-328-4640",
            "fax_number": "252-328-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 MINGES COLISEUM ECU RCLS DEPT.",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278584353",
            "telephone_number": "252-328-4640",
            "fax_number": "252-328-4642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST CAROLINA UNIVERSITY HORIZONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SKALKO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-328-0018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL074127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301318",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

All providers in Greenville, NC · Community/Behavioral Health Agency in North Carolina

Sources for this page

Verify at the official NPI Registry.