Organization
CAROLINA OUTREACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM BROOKS LCSW (CO-DIRECTOR)
(919) 251-9001
Entity
Organization
Contact information
Practice address
911 HAY ST, FAYETTEVILLE, NC 28305-5313
(910) 826-3694
(910) 826-3695
Mailing address
2670 DURHAM CHAPEL HILL BLVD, DURHAM, NC 27707-2829
(919) 251-9001
(919) 251-9008
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3410049
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300219A
—
NC
Enumeration date
07/16/2013
Last updated
07/16/2013
Update your record
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