Organization
WALLTOWN COMMUNITY OUTREACH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALDO NATHAN FENNER (CHIEF EXECUTIVE OFFICER)
(919) 425-5436
Entity
Organization
Contact information
Practice address
1119 CLARENDON ST, DURHAM, NC 27705-3511
(919) 425-5436
Mailing address
1305 WEST BLUB BLVD, DURHAM, NC 27705-3511
(919) 425-5436
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Enumeration date
08/27/2009
Last updated
08/27/2009
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