Organization
COMMUNITY OUTREACH GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FASHENDA L LITTLE (MEMBER)
(919) 539-3659
Entity
Organization
Contact information
Practice address
3600 N DUKE ST, DURHAM, NC 27704-1709
(919) 539-3659
(704) 943-0861
Mailing address
PO BOX 304, WADESBORO, NC 28170-0304
(919) 539-3659
(704) 943-0861
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TBA
—
NC
Enumeration date
05/13/2008
Last updated
05/13/2008
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