Organization
UNITED FAMILY NETWORK INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS SIMMONS I (EXECUTIVE DIRECTOR)
(910) 578-6806
Entity
Organization
Contact information
Practice address
9609 KENNEBEC RD, WILLOW SPRING, NC 27592-9417
(919) 639-1194
Mailing address
9609 KENNEBEC RD, WILLOW SPRING, NC 27592-9417
(919) 639-1194
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-092576
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603685
—
NC
05
—
6603983
—
NC
Enumeration date
02/16/2007
Last updated
09/22/2008
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