Basic Information
| Provider Information | |||||||||
| NPI: | 1164872750 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MORSE CLINIC OF NORTH RALEIGH, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3209 GRESHAM LAKE RD | ||||||||
| Address2: | BUILDING 10, SUITE 113 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276153757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199775993 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3209 GRESHAM LAKE RD | ||||||||
| Address2: | BUILDING 10, SUITE 113 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276153757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199775993 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2016 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| AuthorizedOfficialLastName: | MORSE | ||||||||
| AuthorizedOfficialFirstName: | ERIC | ||||||||
| AuthorizedOfficialMiddleName: | DALTON | ||||||||
| AuthorizedOfficialTitleorPosition: | PROGRAM SPONSOR | ||||||||
| AuthorizedOfficialTelephone: | 9196739681 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 08/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | MHL-092-938 | NC | N | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | 261QR0405X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | 261QM2800X | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
No ID Information.