Organization
116 CRUTCHFIELD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD STOCKHAUSEN (OWNER/MANAGER)
(828) 242-7974
Entity
Organization
Contact information
Practice address
116 CRUTCHFIELD ST, DURHAM, NC 27704-2722
(919) 973-0262
(919) 973-0269
Mailing address
116 CRUTCHFIELD ST, DURHAM, NC 27704-2722
(919) 973-0262
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1359048
NC
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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