Healthcare Provider Details

I. General information

NPI: 1295916682
Provider Name (Legal Business Name): PEOPLE OF PURPOSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 HARBOUR DR
WILMINGTON NC
28401-7716
US

IV. Provider business mailing address

1602 HARBOUR DR
WILMINGTON NC
28401-7716
US

V. Phone/Fax

Practice location:
  • Phone: 910-395-8227
  • Fax: 910-395-9337
Mailing address:
  • Phone: 910-395-8227
  • Fax: 910-395-9337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4790
License Number StateNC

VIII. Authorized Official

Name: NANCY BARNES BOONE
Title or Position: CEO
Credential:
Phone: 252-917-9930