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General NPI Number Information
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NPI Number | 1558594242
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Entity Type | Organization
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Legal Business Name | C&C OUTREACH SERVICES, L.L.C.
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 100 WESTLAKE RD STE 104
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-4871
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Country | US
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Telephone | 910-826-3506
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Fax | 910-826-3507
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Provider Business Mailing Address
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Address Line | PO BOX 1127
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-1127
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Country | US
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Telephone | 910-826-3506
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Fax | 910-826-3507
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA ANESE LEWIS
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Credential |
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Telephone | 910-991-5481
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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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