Healthcare Provider Details

I. General information

NPI: 1164640280
Provider Name (Legal Business Name): FAMILY CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 S MIAMI BLVD SUITE 132
DURHAM NC
27703-5798
US

IV. Provider business mailing address

2310 S MIAMI BLVD SUITE 132
DURHAM NC
27703-5798
US

V. Phone/Fax

Practice location:
  • Phone: 919-818-7733
  • Fax: 919-321-9949
Mailing address:
  • Phone: 919-818-7733
  • Fax: 919-321-9949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DELTON WADE DE VOSE
Title or Position: EXECUTIVE CLINICAL DIRECTOR
Credential: MS, LPC
Phone: 919-818-7733