Organization
PROFESSIONAL GROUP LIVING
Active
Organization
PROFESSIONAL GROUP LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALKA AQUINAIRIA LOCK MASSEY MSW, PLCSW (EXECUTIVE DIRECTOR)
(919) 264-1440
Entity
Organization
Contact information
Practice address
510 SIMMONS ST, DURHAM, NC 27701-4334
(919) 688-0818
(010) 688-0918
Mailing address
510 SIMMONS ST, DURHAM, NC 27701-4334
(919) 688-0818
(010) 688-0918
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301532
—
NC
Enumeration date
01/05/2007
Last updated
02/06/2009
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