Organization
MBS RESTORATIVE CENTRE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELVA DOUGLAS LCSW (OWNER)
(919) 633-9403
Entity
Organization
Contact information
Practice address
1140 KILDAIRE FARM RD STE 206, CARY, NC 27511-4597
(919) 633-9403
(919) 650-1218
Mailing address
1140 KILDAIRE FARM RD STE 206, CARY, NC 27511-4597
(919) 633-1218
(919) 650-1420
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
03/04/2018
Last updated
09/12/2018
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