Organization
INTENTIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE JACKSON (DIRECTOR)
(910) 978-1424
Entity
Organization
Contact information
Practice address
1822 EICHELBERGER DR, FAYETTEVILLE, NC 28303-6257
(910) 978-1424
Mailing address
1822 EICHELBERGER DR, FAYETTEVILLE, NC 28303-6257
(910) 978-1424
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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