Healthcare Provider Details

I. General information

NPI: 1124523386
Provider Name (Legal Business Name): TAKE FLIGHT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 MAIN STREET
PEMBROKE NC
28372
US

IV. Provider business mailing address

PO BOX 2053
GARNER NC
27529-2053
US

V. Phone/Fax

Practice location:
  • Phone: 919-798-0967
  • Fax:
Mailing address:
  • Phone: 919-491-9848
  • 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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: KAREN MCDANIEL
Title or Position: BUSINESS OPERATIONS MANAGER
Credential:
Phone: 910-491-9848