Organization
AMW FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHET WEST (DIRECTOR OF OPERATIONS)
(919) 899-6740
Entity
Organization
Contact information
Practice address
3209 GRESHAM LAKE RD, 113, RALEIGH, NC 27615-4151
(919) 850-2155
(919) 850-2353
Mailing address
3209 GRESHAM LAKE RD, 113, RALEIGH, NC 27615-3757
(919) 850-2155
(919) 850-2353
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005692
—
NC
Enumeration date
01/29/2007
Last updated
11/05/2012
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