Healthcare Provider Details

I. General information

NPI: 1578880233
Provider Name (Legal Business Name): AB FAMILY SUPPORT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81B CENTRAL AVENUE
ASHEVILLE NC
28801-2438
US

IV. Provider business mailing address

81B CENTRAL AVENUE
ASHEVILLE NC
28801-2438
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-4858
  • Fax: 828-254-4857
Mailing address:
  • Phone: 828-254-4858
  • Fax: 828-254-4857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number2722-PSYCHOLOGIST
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number2722-PSYCHOLOGIST
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA S. WILSON
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: PH.D.
Phone: 828-254-4858