Organization
ADMP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LETSIE GENERETTE (QUALIFIED PROFESSIONAL)
(910) 323-0584
Entity
Organization
Contact information
Practice address
131 HAY ST, SUITE 101, FAYETTEVILLE, NC 28301-5649
(910) 323-0584
(910) 323-0566
Mailing address
131 HAY ST, SUITE 101, FAYETTEVILLE, NC 28301-5649
(910) 323-0584
(910) 323-0566
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
026931
NC
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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