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Organization
UNITED FAMILY NETWORK INC.
Active
Organization
UNITED FAMILY NETWORK INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS SIMMONS (EXECUTIVE DIRECTOR)
(919) 749-2767
Entity
Organization
Contact information
Practice address
9609 KENNEBEC RD, WILLOW SPRING, NC 27592-9417
(919) 749-2767
(919) 567-1325
Mailing address
9609 KENNEBEC RD, WILLOW SPRING, NC 27592-9417
(919) 749-2767
(919) 567-1325
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NC
101YM0800X
Mental Health Counselor
—
NC
1041C0700X
Clinical Social Worker
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
WAITING ON MEDICAID PROVIDER NUMBER
NC
Enumeration date
01/06/2010
Last updated
01/06/2010
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