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General NPI Number Information
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NPI Number | 1871873422
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Entity Type | Organization
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Legal Business Name | FAMILY PRESERVATION SERVICES OF NORTH CAROLINA, LLC FLAT ROCK MIDDLE
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 191 PRESTON LN
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City | EAST FLAT ROCK
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State | NC
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Zip | 28726-2865
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Country | US
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Telephone | 704-344-0491
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Fax | 704-344-0493
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Provider Business Mailing Address
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Address Line | PO BOX 759194
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City | BALTIMORE
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State | MD
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Zip | 21275-9194
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Country | US
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Telephone | 828-225-3100
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Fax | 828-225-3604
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Authorized Official
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Title or Position | NC BILLING SYSTEM SUPERVISOR
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Name | PAMELA L FREELEY
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Credential |
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Telephone | 704-344-0491
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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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