Healthcare Provider Details

I. General information

NPI: 1730903550
Provider Name (Legal Business Name): ADVANCEABLE NC ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 INDEPENDENCE BLVD. SUITE. B 1006
WILMINGTON NC
28412
US

IV. Provider business mailing address

4214 W WENDOVER AVE STE 1085
GREENSBORO NC
27407-1909
US

V. Phone/Fax

Practice location:
  • Phone: 948-222-4968
  • Fax: 804-710-2054
Mailing address:
  • Phone: 948-222-4968
  • Fax: 948-222-4968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL WASSNER
Title or Position: CEO
Credential:
Phone: 948-222-4968