Healthcare Provider Details

I. General information

NPI: 1972628709
Provider Name (Legal Business Name): CAROLINA COMMUNITY AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 FAYETTEVILLE ST
DURHAM NC
27707-4133
US

IV. Provider business mailing address

2919 FAYETTEVILLE ST
DURHAM NC
27707-4133
US

V. Phone/Fax

Practice location:
  • Phone: 919-682-4444
  • Fax: 919-682-3333
Mailing address:
  • Phone: 919-682-4444
  • Fax: 919-682-3333

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: MRS. CYNTHIA TERESA ADAMS MANGUM
Title or Position: CLINICAL DIRECTOR
Credential: MA
Phone: 919-682-4444