Organization
DEEPLY ROOTED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLISTINE SIMMONS (CEO)
(252) 287-8713
Entity
Organization
Contact information
Practice address
124 MAIN ST E, AHOSKIE, NC 27910-3416
(252) 332-2025
(252) 332-5099
Mailing address
124 MAIN ST E, AHOSKIE, NC 27910-3416
(252) 332-2025
(252) 332-5099
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/05/2016
Last updated
01/05/2016
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