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General NPI Number Information
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NPI Number | 1417267303
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Entity Type | Organization
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Legal Business Name | CAROLINA FAMILY COMPREHENSIVE SERVICES, INC.
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 801 E. BROAD AVE.
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City | ROCKINGHAM
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State | NC
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Zip | 28379-4382
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Country | US
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Telephone | 910-817-7194
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Fax | 910-817-7198
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Provider Business Mailing Address
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Address Line | 1935 JN PEASE PLACE SUITE 104
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City | CHARLOTTE
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State | NC
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Zip | 28262-4554
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Country | US
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Telephone | 704-548-9600
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KIM RENEE CRUMP
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Credential |
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Telephone | 704-548-9600
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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 |
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License Number State |
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