| Forged By Fire | |
|
1532 Vandenberg Dr Fayetteville NC 28312-7639 | |
| (472) 208-7904 | |
| Not Available |
| Full Name | Forged By Fire |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1532 Vandenberg Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Mary Lynn Campbell (CEO) |
| Authorized Official Contact | 4722087904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forged By Fire 1532 Vandenberg Dr Fayetteville NC 28312-7639 Ph: (472) 208-7904 | Forged By Fire 1532 Vandenberg Dr Fayetteville NC 28312-7639 Ph: (472) 208-7904 |
| NPI Number | 1609691757 |
|---|---|
| Provider Enumeration Date | 11/22/2024 |
| Last Update Date | 12/24/2024 |
| Certification Date | 12/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609691757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 175T00000X | Peer Specialist | (* (Not Available)) | Secondary |
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