Organization · NPI-2

A Legacy Fafilled

Counselor, Addiction (Substance Use Disorder) · Greensboro, NC

NPI number1285027839
StatusActive
Last updated in NPPESMar 6, 2015

Details

NPI
1285027839
Entity type
Organization (NPI-2)
Legal business name
A Legacy Fafilled
Organization subpart
No
Enumeration date
Mar 6, 2015
Last updated
Mar 6, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)––Yes

Practice location

3712 Mizell Rd Apt F
Greensboro, NC 27405-4717

Phone 336-383-7414

Mailing address

3712 Mizell Rd Apt F
Greensboro, NC 27405-4717

Authorized official

Raymond Horne
Owner
3363837414

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Counselor, Addiction (Substance Use Disorder) providers in Greensboro, NC