Provider Demographics
NPI:1164787248
Name:CONCEIVE BELIEVE&ACHIEVE LLC
Entity Type:Organization
Organization Name:CONCEIVE BELIEVE&ACHIEVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALESHIA
Authorized Official - Middle Name:LASHA
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-633-5157
Mailing Address - Street 1:6380 CLIFFDALE RD UNIT 25032
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2970
Mailing Address - Country:US
Mailing Address - Phone:919-633-5157
Mailing Address - Fax:
Practice Address - Street 1:6380 CLIFFDALE RD UNIT 25032
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2970
Practice Address - Country:US
Practice Address - Phone:919-633-5157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management