1508091745 NPI number — ACCESS NC, LLC

Table of content: (NPI 1508091745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508091745 NPI number — ACCESS NC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESS NC, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE CENTER FOR ALTERNATIVE RESOURCES AND EDUCATION
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508091745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
659 CARY TOWNE BLVD
Provider Second Line Business Mailing Address:
#203
Provider Business Mailing Address City Name:
CARY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27511-4219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-460-8522
Provider Business Mailing Address Fax Number:
919-460-8502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2957 OLD STAGE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELCO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28436-9007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-460-8522
Provider Business Practice Location Address Fax Number:
919-460-8502
Provider Enumeration Date:
05/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
LAWSON
Authorized Official First Name:
SHARITA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRINCIPAL
Authorized Official Telephone Number:
919-460-8522

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MHL024079 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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