Provider Demographics
NPI:1083008163
Name:CATHOLIC CHARITIES OF THE DIOCESE OF RALEIGH, INC.
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF RALEIGH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYANO-KLECKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-821-9761
Mailing Address - Street 1:7200 STONEHENGE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1620
Mailing Address - Country:US
Mailing Address - Phone:919-852-9750
Mailing Address - Fax:
Practice Address - Street 1:201 W ASH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3665
Practice Address - Country:US
Practice Address - Phone:919-947-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC004505251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health