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Organization
WORD OF LIFE OURTREACH OF CAPE FEAR, INC.
Active
Organization
WORD OF LIFE OURTREACH OF CAPE FEAR, INC.
Active
Other names
ATLAS at Trinity
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY JOHNSON BA (ADMINISTRATOR)
(910) 371-5300
Entity
Organization
Contact information
Practice address
10241 BLACKWELL RD SE, LELAND, NC 28451-8515
(910) 371-5300
(910) 371-5302
Mailing address
PO BOX 717, LELAND, NC 28451-0717
(910) 371-5300
(910) 371-5302
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL 010-061
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301346G
—
NC
05
—
8302371R
—
NC
05
—
8302371S
—
NC
Enumeration date
04/30/2009
Last updated
04/30/2009
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