Organization
STRUCTURED CHAOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE JENNETTE (OWNER)
(919) 389-7686
Entity
Organization
Contact information
Practice address
700 MARSH GRASS DR, RALEIGH, NC 27610-2194
(919) 389-7686
Mailing address
700 MARSH GRASS DR, RALEIGH, NC 27610-2194
(919) 389-7686
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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