Healthcare Provider Details

I. General information

NPI: 1801024583
Provider Name (Legal Business Name): THE FAMILY ENRICHMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E H ST
ERWIN NC
28339-2144
US

IV. Provider business mailing address

110 E H ST
ERWIN NC
28339-2144
US

V. Phone/Fax

Practice location:
  • Phone: 910-892-6174
  • Fax: 910-892-6359
Mailing address:
  • Phone: 910-892-6174
  • Fax: 910-892-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: PAMELA BRAZIL
Title or Position: DIRECTOR
Credential:
Phone: 910-892-6174