=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053745992
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUST THE PROCESS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2013
-----------------------------------------------------
Last Update Date | 09/24/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2110 MURCHISON RD
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28301-3644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-488-9009
-----------------------------------------------------
Fax | 910-822-9090
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 904 W BROAD ST SUITE B
-----------------------------------------------------
City | DUNN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28334-4100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-292-2518
-----------------------------------------------------
Fax | 910-292-2556
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ANNIE KAREN KELLY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 910-292-2518
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | MHL043091
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | MHL043091
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------