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Organization

BRANCHING OUT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LIANE KENYA CHESTNUT (DIRECTOR)
(919) 884-1542
Entity
Organization

Contact information

Practice address
412 W MARKHAM AVE, DURHAM, NC 27701-1616
(919) 884-1542
Mailing address
412 WEST MARKHAM AVE, DURHAM, NC 27701
(919) 884-1542

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
07/27/2009
Last updated
07/27/2009
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