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General NPI Number Information
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NPI Number | 1194876425
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Entity Type | Organization
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Legal Business Name | FAMILY SOLUTIONS CENTER
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 137 HIDDEN CREEK DR
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City | ADVANCE
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State | NC
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Zip | 27006-8754
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Country | US
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Telephone | 336-998-1652
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Fax | 336-998-1652
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Provider Business Mailing Address
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Address Line | 137 HIDDEN CREEK DR
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City | ADVANCE
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State | NC
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Zip | 27006-8754
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Country | US
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Telephone | 336-998-1652
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Fax | 336-998-1652
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. WILLENE TILLMAN
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Credential |
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Telephone | 336-998-1652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | NC
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