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Organization

E SQUARED COMMUNITY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. EMILY D LEAK (PRESIDENT)
(919) 218-7161
Entity
Organization

Contact information

Practice address
105 N RUTHERFORD ST, WADESBORO, NC 28170-2130
(704) 994-2640
(704) 994-2624
Mailing address
5022 ISABELLA CANNON DR, RALEIGH, NC 27612-4804
(919) 218-7161
(919) 327-6813

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-004-030
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8301695
NC
Enumeration date
02/21/2011
Last updated
02/21/2011
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