Organization
CROSS CREEK FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BIANCA P GANTT LCSW (ADMINISTRATIVE DIR)
(910) 273-5066
Entity
Organization
Contact information
Practice address
150B SQUARE LN, SHANNON, NC 28386-9035
(910) 222-8193
(910) 488-1122
Mailing address
PO BOX 432, FAYETTEVILLE, NC 28302-0432
(910) 222-8193
(910) 488-1122
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/30/2009
Last updated
08/30/2009
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