Healthcare Provider Details

I. General information

NPI: 1508796376
Provider Name (Legal Business Name): FACILITY CARE CLINICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 WAKE FOREST RD STE 349
RALEIGH NC
27609-0010
US

IV. Provider business mailing address

4030 WAKE FOREST RD STE 349
RALEIGH NC
27609-0010
US

V. Phone/Fax

Practice location:
  • Phone: 980-467-9602
  • Fax:
Mailing address:
  • Phone: 980-467-9602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SUSAN ESTRELA
Title or Position: FOUNDER/CLINICAL DIRECTOR
Credential: LCSW
Phone: 980-467-9602