Healthcare Provider Details

I. General information

NPI: 1730536186
Provider Name (Legal Business Name): FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2016
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 BILTMORE AVE
ASHEVILLE NC
28801-4157
US

IV. Provider business mailing address

PO BOX 759194
BALTIMORE MD
21275-9195
US

V. Phone/Fax

Practice location:
  • Phone: 877-277-8873
  • Fax: 828-505-0366
Mailing address:
  • Phone: 704-344-0491
  • Fax: 704-344-0493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PAMELA L FREELEY
Title or Position: NC BILLING SYSTEMS SUPERVISOR
Credential:
Phone: 704-344-0491