Provider Demographics
NPI:1124363270
Name:M & Q ENTERPRISE, INC.
Entity Type:Organization
Organization Name:M & Q ENTERPRISE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCAS-A
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:336-268-6469
Mailing Address - Street 1:4037 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1227
Mailing Address - Country:US
Mailing Address - Phone:336-268-6469
Mailing Address - Fax:336-333-2858
Practice Address - Street 1:4037 PAYNE RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1227
Practice Address - Country:US
Practice Address - Phone:336-268-6469
Practice Address - Fax:336-333-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health