Organization
NC FAMILY EMPOWERMENT ZONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY EUGEN GROSS (PRESIDENT)
(757) 831-2921
Entity
Organization
Contact information
Practice address
2012 N ROAD ST, SUITE 101, ELIZABETH CITY, NC 27909-9361
(757) 831-2921
Mailing address
PO BOX 2717, ELIZABETH CITY, NC 27906-2717
(757) 831-2921
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
19778
NC
Other
Enumeration date
07/29/2008
Last updated
07/29/2008
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