| Manifest Family Services | |
|
110 Stockton St Ste M Statesville NC 28677-5253 | |
| (980) 446-0004 | |
| (980) 446-0004 |
| Full Name | Manifest Family Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 110 Stockton St Ste M, Statesville, North Carolina |
| Authorized Official Name and Position | Marguerite Anne Allen (PROGRAM DIRECTOR) |
| Authorized Official Contact | 9804460004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manifest Family Services Po Box 1702 Statesville NC 28687-1702 Ph: (980) 446-0004 | Manifest Family Services 110 Stockton St Ste M Statesville NC 28677-5253 Ph: (980) 446-0004 |
| NPI Number | 1033700836 |
|---|---|
| Provider Enumeration Date | 02/03/2021 |
| Last Update Date | 06/18/2021 |
| Certification Date | 06/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033700836 | NPI | - | NPPES |
| 6104321 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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