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General NPI Number Information
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NPI Number | 1316349772
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Entity Type | Organization
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Legal Business Name | THE T ALLEN GROUP LLC
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 1409 PINCKNEY ST
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City | WHITEVILLE
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State | NC
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Zip | 28472-2220
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Country | US
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Telephone | 919-820-2554
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Fax | 855-640-5434
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Provider Business Mailing Address
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Address Line | 227 WENDY PL
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City | BENSON
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State | NC
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Zip | 27504-7997
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Country | US
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Telephone | 919-820-2554
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Fax | 855-640-5434
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Authorized Official
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Title or Position | OWNER
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Name | TERESA ALLEN
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Credential |
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Telephone | 919-820-2554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 253205
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 9801445
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 9801445
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License Number State | NC
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