Organization
FAMILY ALTERNATIVE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYETTA SHAW (DIRECTOR)
(704) 575-2708
Entity
Organization
Contact information
Practice address
3205 MALLARD HILL DR, 107, CHARLOTTE, NC 28269-2023
(704) 575-2708
Mailing address
PO BOX 28, NEWELL, NC 28126-0028
(704) 575-2708
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
SC
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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