Individual
KEVIN FAISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, QP
Contact information
Practice address
3219 LANDMARK ST, GREENVILLE, NC 27834-7688
(252) 814-0026
Mailing address
2203 OLD COURTHOUSE DR, GREENVILLE, NC 27858-5675
(252) 814-0026
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
NC
172A00000X
Driver
—
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NC
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
NC
374U00000X
Home Health Aide
—
—
Other
Enumeration date
05/13/2020
Last updated
07/28/2020
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