Organization
FOOTPRINTS OF LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY SLADE (OWNER)
(919) 697-1850
Entity
Organization
Contact information
Practice address
3120-B ZEBULON RD., ROCKY MOUNT, NC 27804
(919) 697-1850
Mailing address
1802 PENNYPACKER LN, DURHAM, NC 27703-7974
(919) 697-1850
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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