Healthcare Provider Details

I. General information

NPI: 1144417460
Provider Name (Legal Business Name): ALATYMI COUNSELING CONSULTANTS & FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E PILOT ST
DURHAM NC
27707-3032
US

IV. Provider business mailing address

312 E ALTON ST
DURHAM NC
27707-3005
US

V. Phone/Fax

Practice location:
  • Phone: 919-680-0334
  • Fax: 919-688-3559
Mailing address:
  • Phone: 919-688-3559
  • Fax: 919-688-3559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberMHL-032-401
License Number StateNC

VIII. Authorized Official

Name: MS. AVA VERNELL HINTON
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 919-688-3559