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Organization

UNC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CONSTANCE A RENZ LCSW (DIRECTOR)
(919) 966-9803
Entity
Organization

Contact information

Practice address
209 CONNER DR APT 17, CHAPEL HILL, NC 27514-7023
(919) 960-3775
Mailing address
400 ROBERSON ST, CARRBORO, NC 27510-2367
(919) 966-9803

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
068107
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8300699B
NC
Enumeration date
01/02/2008
Last updated
01/02/2008
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