Organization
ANNIE'S HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORLANDER A. BULLOCK (CHIEF EXECUTIVE OFFICER)
(919) 426-2146
Entity
Organization
Contact information
Practice address
1784 HERITAGE CENTER DR STE 204-H, WAKE FOREST, NC 27587-3989
(919) 426-2146
Mailing address
1784 HERITAGE CENTER DR STE 204-H, WAKE FOREST, NC 27587-3989
(919) 426-2146
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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