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General NPI Number Information
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NPI Number | 1588801336
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Entity Type | Organization
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Legal Business Name | VALIANT FAMILIES, PC
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 1153 JEFFREYS RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-1866
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Country | US
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Telephone | 252-451-4451
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Fax | 252-454-0009
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Provider Business Mailing Address
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Address Line | 1153 JEFFREYS RD PO BOX 8064
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-1866
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Country | US
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Telephone | 252-451-4451
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Fax | 252-454-0009
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VICTOR LARUE JONES
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Credential | MSW, LCSW
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Telephone | 252-451-4451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C003192
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License Number State | NC
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