Healthcare Provider Details

I. General information

NPI: 1003641010
Provider Name (Legal Business Name): QUALITY CARE BEHAVIORAL HEALTH & COUNSELING SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E ACADEMY ST
FUQUAY VARINA NC
27526-2248
US

IV. Provider business mailing address

PO BOX 2827
LILLINGTON NC
27546-2827
US

V. Phone/Fax

Practice location:
  • Phone: 919-247-1221
  • Fax:
Mailing address:
  • Phone: 919-247-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ALIEDJAWON PEOPLES
Title or Position: OWNER
Credential: LCSW, CCTP
Phone: 919-247-1221