| Annie's House, Llc | |
|
1784 Heritage Center Dr Ste 204-h Wake Forest NC 27587-3989 | |
| (919) 426-2146 | |
| Not Available |
| Full Name | Annie's House, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1784 Heritage Center Dr Ste 204-h, Wake Forest, North Carolina |
| Authorized Official Name and Position | Orlander A. Bullock (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9194262146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Annie's House, Llc 1784 Heritage Center Dr Ste 204-h Wake Forest NC 27587-3989 Ph: (919) 426-2146 | Annie's House, Llc 1784 Heritage Center Dr Ste 204-h Wake Forest NC 27587-3989 Ph: (919) 426-2146 |
| NPI Number | 1275164196 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 01/29/2020 |
| Certification Date | 01/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275164196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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