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Organization
WE ARE 1
Active
Organization
WE ARE 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ANTHONY HOLLIS (OWNER)
(919) 793-5914
Entity
Organization
Contact information
Practice address
1530 EVANS ST STE 207-208, GREENVILLE, NC 27834-5301
(919) 793-5914
Mailing address
4011 NORTHSTONE DR APT 108, RALEIGH, NC 27604-4186
(919) 793-5914
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
7949919
NC
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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