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General NPI Number Information
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NPI Number | 1720274509
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Entity Type | Organization
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Legal Business Name | SOPHIA B PIERCE & ASSOCIATES INC
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 12/03/2018
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Provider Practice Location Address
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Address Line | 1909 STANBERRY PLACE
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City | FAYETTEVILLE
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State | NC
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Zip | 28301
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Country | US
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Telephone | 910-488-7436
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Fax | 910-822-1951
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Provider Business Mailing Address
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Address Line | PO BOX 2813
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City | FAYETTEVILLE
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State | NC
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Zip | 28302
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Country | US
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Telephone | 910-488-8477
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Fax | 910-822-1951
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. SOPHIA BLANKS PIERCE
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Credential | PHD
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Telephone | 910-488-8477
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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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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | MHL026299
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | MHL-026-299
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License Number State | NC
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