Organization
NC MENTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATWANA OLIVER PLCSW (FAMILY SUPPORT SPECIALIST)
(919) 345-8012
Entity
Organization
Contact information
Practice address
3125 POPLARWOOD COURT, SUITE 300, RALEIGH, NC 27604
(919) 345-8012
Mailing address
3125 POPLARWOOD CT, SUITE 300, RALEIGH, NC 27604-1084
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
P006264
NC
Other
Enumeration date
05/09/2012
Last updated
05/09/2012
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