Organization
E SQUARED COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY DIANE LEAK (PRESIDENT)
(919) 218-7161
Entity
Organization
Contact information
Practice address
123 W PALMER ST, RAEFORD, NC 28376-9359
(910) 904-7170
(910) 904-7171
Mailing address
PO BOX 388, LILLINGTON, NC 27546-5830
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/13/2007
Last updated
03/19/2010
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