Organization
INNOVATIVE FAMILY SUPPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDICE BYNUM (DIRECTOR)
(919) 985-3151
Entity
Organization
Contact information
Practice address
103 DRESSER CT, RALEIGH, NC 27609
(919) 985-3151
Mailing address
7908 CLOVER CREEK CT, RALEIGH, NC 27613-5217
(919) 985-3151
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/17/2012
Last updated
04/17/2012
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