| A Legacy Fafilled | |
|
3712 Mizell Rd Apt F Greensboro NC 27405-4717 | |
| (336) 383-7414 | |
| Not Available |
| Full Name | A Legacy Fafilled |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 3712 Mizell Rd Apt F, Greensboro, North Carolina |
| Authorized Official Name and Position | Raymond Horne (OWNER) |
| Authorized Official Contact | 3363837414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Legacy Fafilled 3712 Mizell Rd Apt F Greensboro NC 27405-4717 Ph: () - | A Legacy Fafilled 3712 Mizell Rd Apt F Greensboro NC 27405-4717 Ph: (336) 383-7414 |
| NPI Number | 1285027839 |
|---|---|
| Provider Enumeration Date | 03/06/2015 |
| Last Update Date | 03/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285027839 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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