Organization
NC DHHS CHILD AND FAMILY WELL-BEING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QIUDI WANG (OPERATIONS MANAGER)
(919) 707-5527
Entity
Organization
Contact information
Practice address
1065 VINEHAVEN DR, CONCORD, NC 28025-2439
(704) 786-9181
(704) 792-9198
Mailing address
DPH- EARLY INTERVENTION BR, 1916 MAIL SERVICE CENTER, RALEIGH, NC 27699-1916
(919) 707-5520
(919) 870-4834
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3403408
—
NC
01
—
3405
BLUE CROSS BLUE SHIELD
NC
Enumeration date
04/13/2007
Last updated
07/20/2023
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