Organization
NOVA FAMILY LIFE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY CLARK OWENS MED (PROGRAM DIRECTOR)
(910) 867-2960
Entity
Organization
Contact information
Practice address
6454 RUTHERGLEN DR, FAYETTEVILLE, NC 28304-3964
(910) 867-2960
(910) 717-7715
Mailing address
2390 VARA DR, FAYETTEVILLE, NC 28304-2788
(910) 867-2960
(910) 717-7715
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Enumeration date
02/24/2007
Last updated
08/22/2020
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