Organization
NORTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY SULLIVAN (EXECUTIVE DIRECTOR)
(919) 781-0661
Entity
Organization
Contact information
Practice address
4505 FAIR MEADOWS LN, SUITE 203, RALEIGH, NC 27607-6465
(919) 781-0661
(919) 881-6580
Mailing address
PO BOX 445, ABERDEEN, NC 28315-0445
(910) 944-8125
(910) 944-3984
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408784
—
NC
05
—
3418526
—
NC
05
—
6005619
—
NC
Enumeration date
09/20/2006
Last updated
03/18/2009
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