| Crandell's Enterprise's Inc. | |
|
5312 Six Forks Rd 301 Raleigh NC 27609-4458 | |
| (919) 790-7663 | |
| (919) 790-7139 |
| Full Name | Crandell's Enterprise's Inc. |
|---|---|
| Speciality | Counselor |
| Location | 5312 Six Forks Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Sandra Mayo (MANAGER) |
| Authorized Official Contact | 9197907663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crandell's Enterprise's Inc. 5312 Six Forks Rd 301 Raleigh NC 27609-4458 Ph: (919) 790-7663 | Crandell's Enterprise's Inc. 5312 Six Forks Rd 301 Raleigh NC 27609-4458 Ph: (919) 790-7663 |
| NPI Number | 1346477098 |
|---|---|
| Provider Enumeration Date | 06/19/2009 |
| Last Update Date | 03/08/2021 |
| Certification Date | 03/08/2021 |
| Medicare PECOS PAC ID | 0143401661 |
|---|---|
| Medicare Enrollment ID | O20110216000858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346477098 | NPI | - | NPPES |
| Provider Name | Dwan T Kelsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629297429 PECOS PAC ID: 8921060203 Enrollment ID: I20041029000060 |
| Provider Name | Larry L Hines |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003972050 PECOS PAC ID: 4486717493 Enrollment ID: I20090116000069 |
| Provider Name | Sondra Huffman Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366747412 PECOS PAC ID: 6002097011 Enrollment ID: I20110224000212 |
| Provider Name | Jamilah B Mcclain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225239270 PECOS PAC ID: 6103056130 Enrollment ID: I20140313000002 |
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