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Organization
VISION
Active
Organization
VISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDDIE LEE WILLIAMS (DIRECTOR)
(919) 479-6917
Entity
Organization
Contact information
Practice address
3671 GUESS RD, DURHAM, NC 27705-6908
(919) 479-6917
(919) 471-3904
Mailing address
PO BOX 14281, RESEARCH TRIANGLE PARK, NC 27709-4281
(919) 479-6917
(919) 471-3904
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-032-468
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
66043620
—
NC
Enumeration date
02/23/2009
Last updated
02/23/2009
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