Organization
ENOC MADERO
Active
Other names
Our Kids, Nuestros Ninos
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ENOC E MADERO M.A., ITFS (OWNER, DEVELOPMENTAL THERAPIST)
(919) 593-7602
Entity
Organization
Contact information
Practice address
6036 BRAMBLEBERRY WAY, RALEIGH, NC 27616-6618
(919) 593-7602
Mailing address
6036 BRAMBLEBERRY WAY, RALEIGH, NC 27616-6618
(919) 593-7602
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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