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General NPI Number Information
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NPI Number | 1982735239
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Entity Type | Organization
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Legal Business Name | THE JANICE MAE HAWKINS FOUNDATION, INC.
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 3359 GABLES DR.
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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 | 910-864-3426
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Fax | 910-764-1457
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Provider Business Mailing Address
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Address Line | 3359 GABLES DR.
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-0340
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Country | US
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Telephone | 910-864-3426
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Fax | 910-491-6803
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Authorized Official
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Title or Position | CEO ADMINISTRATOR
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Name | PROF. SHERYL ANNETTE LYONS
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Credential | RN, BSN, SANE, CLNC,
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Telephone | 910-864-3426
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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 | MHL-026-809
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License Number State | NC
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