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General NPI Number Information
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NPI Number | 1891947560
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Entity Type | Organization
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Legal Business Name | ESTEEM FAMILY LIFE CENTER LLC
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 03/28/2009
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Provider Practice Location Address
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Address Line | 1219 ROCKINGHAM RD SUITE 10
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City | ROCKINGHAM
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State | NC
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Zip | 28379-4925
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Country | US
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Telephone | 910-997-4926
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Fax | 910-997-4927
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Provider Business Mailing Address
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Address Line | 1219 ROCKINGHAM RD SUITE 10
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City | ROCKINGHAM
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State | NC
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Zip | 28379-4925
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Country | US
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Telephone | 910-997-4926
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Fax | 910-997-4927
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Authorized Official
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Title or Position | CEO
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Name | MR. COLEY SCAGLIARINI
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Credential |
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Telephone | 704-942-0999
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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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