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Organization

ACHIEVABLE THERAPEUTIC INTERVENTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DARRYL POWELL PEEBLES JR. (EXECUTIVE DIRECTOR)
(919) 412-7502
Entity
Organization

Contact information

Practice address
5421 OLD POOLE RD STE 107, RALEIGH, NC 27610-3285
(919) 231-2261
(919) 231-2219
Mailing address
109 SMART CT, CLAYTON, NC 27520-1849
(919) 412-7502
(919) 231-2219

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
NC
252Y00000X
Early Intervention Provider Agency
Primary
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6006910
NC
Enumeration date
04/12/2007
Last updated
02/02/2012
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