Organization
FUNDAMENTAL HEALTH RESOURCES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KWAME KAMALA WOODS BA CSAC-R QP (CEO)
(919) 539-6661
Entity
Organization
Contact information
Practice address
4816 LOGANSHIRE LN, RALEIGH, NC 27616-2974
(919) 539-6661
(000) 000-0000
Mailing address
PO BOX 28887, RALEIGH, NC 27611-8887
(919) 539-6661
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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