Provider Demographics
NPI:1164640280
Name:FAMILY CONNECTIONS
Entity Type:Organization
Organization Name:FAMILY CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DELTON
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:DE VOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:919-818-7733
Mailing Address - Street 1:2310 S MIAMI BLVD
Mailing Address - Street 2:SUITE 132
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5798
Mailing Address - Country:US
Mailing Address - Phone:919-818-7733
Mailing Address - Fax:919-321-9949
Practice Address - Street 1:2310 S MIAMI BLVD
Practice Address - Street 2:SUITE 132
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5798
Practice Address - Country:US
Practice Address - Phone:919-818-7733
Practice Address - Fax:919-321-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251S00000XAgenciesCommunity/Behavioral Health