Organization
FAMILY HABILITATIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KENYETTA SHAW (DIRECTOR)
(910) 487-5490
Entity
Organization
Contact information
Practice address
3441 LUBBOCK DR, HOPE MILLS, NC 28348-9637
(910) 487-5490
(910) 864-1781
Mailing address
3441 LUBBOCK DR, HOPE MILLS, NC 28348-9637
(910) 487-5490
(910) 864-1781
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408287
—
NC
Enumeration date
04/04/2007
Last updated
06/25/2008
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