Provider Demographics
NPI:1659660165
Name:ST. PAUL'S CENTER FOR HOPE AND HEALING
Entity type:Organization
Organization Name:ST. PAUL'S CENTER FOR HOPE AND HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, REVEREND
Authorized Official - Phone:919-467-1477
Mailing Address - Street 1:221 UNION ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3763
Mailing Address - Country:US
Mailing Address - Phone:919-467-1477
Mailing Address - Fax:919-467-0152
Practice Address - Street 1:221 UNION ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3763
Practice Address - Country:US
Practice Address - Phone:919-467-1477
Practice Address - Fax:919-467-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
APPLIED FOR251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health