Healthcare Provider Details

I. General information

NPI: 1821763749
Provider Name (Legal Business Name): VETERANS EMPOWERING VETERANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 B ST
FAYETTEVILLE NC
28301-5129
US

IV. Provider business mailing address

325 B ST
FAYETTEVILLE NC
28301-5129
US

V. Phone/Fax

Practice location:
  • Phone: 910-223-3213
  • Fax: 910-223-3213
Mailing address:
  • Phone: 910-223-3213
  • Fax: 910-223-3213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINA MARIE ELDER
Title or Position: LEAD SOCIAL WORKER
Credential: MSW, LCSWA
Phone: 910-223-3213