Provider Demographics
NPI:1114173341
Name:CAROLINA FAMILY COMPREHENSIVE SERVICES, INC.
Entity Type:Organization
Organization Name:CAROLINA FAMILY COMPREHENSIVE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-548-9600
Mailing Address - Street 1:1935 JN PEASE PLACE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4554
Mailing Address - Country:US
Mailing Address - Phone:704-548-9600
Mailing Address - Fax:704-548-9666
Practice Address - Street 1:1935 JN PEASE PLACE
Practice Address - Street 2:SUITE 104
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4554
Practice Address - Country:US
Practice Address - Phone:704-548-9600
Practice Address - Fax:704-548-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty