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Organization

AMW FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHESTER MCKINLEY WEST (DIRECTOR OF OPERATIONS)
(919) 850-2155
Entity
Organization

Contact information

Practice address
3209 GRESHAM LAKE RD, SUITE113, RALEIGH, NC 27615-3757
(919) 850-2155
(919) 850-2325
Mailing address
5012D LANSING DR, WINSTON SALEM, NC 27105
(919) 850-2155
(919) 850-2325

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6008133
NC
Enumeration date
09/29/2010
Last updated
09/29/2010
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