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General NPI Number Information
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NPI Number | 1326910415
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Entity Type | Organization
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Legal Business Name | CRAVEN TERRACE CHARITIES INC
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 10085 RIO SAN DIEGO DR APT 337
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City | SAN DIEGO
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State | CA
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Zip | 92108-5680
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Country | US
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Telephone | 252-626-7732
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Fax |
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Provider Business Mailing Address
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Address Line | 109 FAWN TRL
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City | JACKSONVILLE
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State | NC
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Zip | 28540-4595
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Country | US
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Telephone | 252-626-7732
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Fax |
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Authorized Official
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Title or Position | BUSINESS DIRECTOR
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Name | MR. JOSHUA M CHITALO
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Credential |
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Telephone | 252-626-7732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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