Organization
UNC
Active
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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