Provider Demographics
NPI:1184107542
Name:SANDHILLS INTERGRATED CARE, INC.
Entity type:Organization
Organization Name:SANDHILLS INTERGRATED CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LACHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-756-3008
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-0532
Mailing Address - Country:US
Mailing Address - Phone:843-756-3008
Mailing Address - Fax:843-756-3128
Practice Address - Street 1:1409 PINCKNEY ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-2220
Practice Address - Country:US
Practice Address - Phone:910-914-6453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1184107542Medicaid
SCGP8411Medicaid