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General NPI Number Information
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NPI Number | 1013326222
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Entity Type | Organization
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Legal Business Name | R4 THERAPEUTIC SOLUTIONS, PLLC
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 690 N REILLY RD SUITE 2
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-5724
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Country | US
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Telephone | 910-973-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 GREEN VALLEY ROAD
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City | FAYETTEVILLE
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State | NC
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Zip | 28301
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Country | US
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Telephone | 910-488-6478
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Fax |
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Authorized Official
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Title or Position | LPC/OWNER
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Name | MS. DE'LISA M HILL
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Credential | MA, LPC, NCC, BCPC
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Telephone | 910-973-0024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 7718
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License Number State | NC
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