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NPI Code Detail

MEDICARE: FAMILY PRESERVATION SERVICES OF NC, INC.

MEDICARE: FAMILY PRESERVATION SERVICES OF NC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

General Provider Information

NPI Number : 1194863043
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY PRESERVATION SERVICES OF NC, INC.
Provider Business Mailing Address
First Line : PO BOX 759194
Second Line :
City : BALTIMORE
State : MD
Zip : 21275-9194
Country : US
Telephone Number : 828-225-3100
Fax Number : 828-225-3604
Provider Business Practice Location Address
First Line : 941 W ANDREWS AVE STE I
Second Line :
City : HENDERSON
State : NC
Zip : 27536-2586
Country : US
Telephone Number : 252-438-4740
Fax Number :
Authorized Official
Title or Position : NC QI & TRAINING DIR
Name : MIRANDA KAYE LITTLE
Credential :
Telephone Number : 704-344-0491
Provider Enumeration Date : 02/02/2007
Last Update Date : 02/10/2014

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Directions to “FAMILY PRESERVATION SERVICES OF NC, INC. ” Practice Location

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