Healthcare Provider Details

I. General information

NPI: 1063571131
Provider Name (Legal Business Name): ACCESS FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELLINGTON AVE
WILMINGTON NC
28401-7652
US

IV. Provider business mailing address

PO BOX 19649
CHARLOTTE NC
28219-9649
US

V. Phone/Fax

Practice location:
  • Phone: 910-392-4881
  • Fax: 910-392-9559
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ROB NICOLAI
Title or Position: BILLING DIRECTOR
Credential:
Phone: 828-670-7723