116 Crutchfield
Community/Behavioral Health in Durham, NC. Organization (NPI-2).
NPI number1487070785
StatusActive
Last updated in NPPESMar 11, 2014
Details
- NPI
- 1487070785
- Entity type
- Organization (NPI-2)
- Legal business name
- 116 Crutchfield
- Organization subpart
- No
- Enumeration date
- Mar 11, 2014
- Last updated
- Mar 11, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | 1359048 | NC | Yes |
Practice location
116 Crutchfield StDurham, NC 27704-2722
Phone 919-973-0262 · Fax 919-973-0269
Mailing address
116 Crutchfield StDurham, NC 27704-2722
Phone 919-973-0262
Authorized official
Edward Stockhausen
Owner/Manager
8282427974
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