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General NPI Number Information
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NPI Number | 1760734495
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Entity Type | Organization
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Legal Business Name | ARJ LLC #2
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 2215 MURCHISON RD STE 3&4
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-3567
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Country | US
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Telephone | 910-703-8710
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Fax |
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Provider Business Mailing Address
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Address Line | 2215 MURCHISON RD STE 3&4
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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 |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. ALVIN JASPER
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Credential |
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Telephone | 704-910-5395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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