1508049412 NPI number — FAMILIES TOGETHER, INC.

Table of content: NANCY LYNCH GIBSON LCPC (NPI 1972873669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508049412 NPI number — FAMILIES TOGETHER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILIES TOGETHER, INC.
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:
Provider Other Organization Name Type Code:
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:
1508049412
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
512 N GROVE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSONVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28792-4489
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
512 N GROVE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28792-4489
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-337-8115
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WEAVER
Authorized Official First Name:
AUDREY
Authorized Official Middle Name:
F
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
828-258-0031

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8301580B , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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