Organization
CAROLINA OUTREACH, LLC
Active
Parent organization
CAROLINA OUTREACH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINA OUTREACH, LLC
Authorized official
JAMES MITCHELL VEDDER (CFO)
(703) 844-1007
Entity
Organization
Contact information
Practice address
2508 APRIL LIU LN APT 311, CHARLOTTE, NC 28213-6966
(704) 332-8787
Mailing address
2670 DURHAM CHAPEL HILL BLVD, DURHAM, NC 27707-2829
(720) 402-2296
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08300219
—
NC
Enumeration date
03/07/2023
Last updated
03/07/2023
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