Organization
EMPLOYMENT SOURCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUY W KLENKE (SR VP SOUTH REGION)
(321) 639-7068
Entity
Organization
Contact information
Practice address
600 AMES STREET, FAYETTEVILLE, NC 28301
(910) 826-4699
(910) 485-4341
Mailing address
600 AMES STREET, FAYETTEVILLE, NC 28301
(910) 826-4699
(910) 485-4341
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/10/2007
Last updated
08/22/2020
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