Healthcare Provider Details

I. General information

NPI: 1265595813
Provider Name (Legal Business Name): FAMILY ALTERNATIVES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 E. GREEN STREET
CLARKTON NC
28433
US

IV. Provider business mailing address

PO BOX 963
LUMBERTON NC
28359-0963
US

V. Phone/Fax

Practice location:
  • Phone: 910-647-0064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: LAVERN S. OXENDINE
Title or Position: DIRECTOR
Credential:
Phone: 910-739-6624