Extended Reach Day Treatment For Children And Adolescents, Llc

LBN: Extended Reach Day Treatment For Children And Adolescents, Llc
Extended Reach Day Treatment For Children And Adolescents, Llc is an health care organization with primary practice located at 2716 Custer Ave , Fayetteville NC 28312-7814. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Extended Reach Day Treatment For Children And Adolescents, Llc can be contacted via phone (910) 484-0095, or through Boatman-Hall, Andrea Monique via phone (910) 229-8256.

Contact Information

Primary practice address
2716 Custer Ave Fayetteville NC 28312-7814
Phone: (910) 484-0095
Fax: (919) 238-7238
Website:
Map and Directions
Authorized official contact:
Name: Boatman-Hall, Andrea Monique
Phone: (910) 229-8256

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1487829248
LBN Legal business name Extended Reach Day Treatment For Children And Adolescents, Llc
DBA Doing business as
Authorized official Boatman-Hall, Andrea Monique
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2008
Last updated May 27th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487829248 NPPES
North Carolina MEDICAID 8302339
North Carolina MEDICAID 6006927

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