Alase Center For Enrichment Ii | |
6015 Fayetteville Rd Suite 114 Durham NC 27713 | |
(919) 957-7357 | |
(919) 957-9539 |
Full Name | Alase Center For Enrichment Ii |
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Speciality | Community/Behavioral Health |
Location | 6015 Fayetteville Rd, Durham, North Carolina |
Authorized Official Name and Position | Towanna Brinkley (OFFICE MANAGER) |
Authorized Official Contact | 9199577357 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Alase Center For Enrichment Ii 6015 Fayetteville Rd Suite 114 Durham NC 27713 Ph: (919) 957-7357 | Alase Center For Enrichment Ii 6015 Fayetteville Rd Suite 114 Durham NC 27713 Ph: (919) 957-7357 |
NPI Number | 1558554675 |
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Provider Enumeration Date | 08/22/2007 |
Last Update Date | 09/12/2022 |
Certification Date | 09/12/2022 |
Medicare PECOS PAC ID | 7618235086 |
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Medicare Enrollment ID | O20171213002168 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558554675 | NPI | - | NPPES |
6005138 | Medicaid | NC |
Provider Name | Anthony J Smith |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1740347004 PECOS PAC ID: 4688712797 Enrollment ID: I20091110000690 |
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