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General NPI Number Information
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NPI Number | 1720221559
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Entity Type | Organization
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Legal Business Name | INTEGRATED FAMILY SERVICES, PLLC
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 1308 HIGHLAND DR
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City | WASHINGTON
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State | NC
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Zip | 27889-3424
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Country | US
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Telephone | 252-946-3690
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Fax | 252-946-2452
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Provider Business Mailing Address
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Address Line | PO BOX 885
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City | AHOSKIE
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State | NC
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Zip | 27910-0885
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Country | US
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Telephone | 252-862-4411
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Fax | 252-862-4414
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MR. ANTHONY JEROME MANLEY-ROOK
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Credential | LCSW
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Telephone | 252-862-4411
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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 | C003507
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License Number State | NC
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