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General NPI Number Information
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NPI Number | 1558558197
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Entity Type | Organization
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Legal Business Name | POSITIVE FUTURE, LLC
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 220 WINFALL BLVD SUITE 3
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City | HERTFORD
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State | NC
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Zip | 27944-8829
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Country | US
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Telephone | 252-426-7537
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Fax | 252-426-1877
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Provider Business Mailing Address
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Address Line | PO BOX 207
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City | WINFALL
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State | NC
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Zip | 27985-0207
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Country | US
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Telephone | 252-426-7537
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Fax | 252-426-1877
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Authorized Official
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Title or Position | OWNER
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Name | MISS CRYSTAL LYNETTE LEE
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Credential |
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Telephone | 252-426-7537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NC
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