Provider Demographics
NPI:1174664528
Name:FAMILY FOCUSED, LLC
Entity Type:Organization
Organization Name:FAMILY FOCUSED, LLC
Other - Org Name:FAMILY FOCUSED, LLC @TREYBURN COURT
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, QP
Authorized Official - Phone:910-763-3073
Mailing Address - Street 1:7414 TREYBURN DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7351
Mailing Address - Country:US
Mailing Address - Phone:910-527-7881
Mailing Address - Fax:
Practice Address - Street 1:2415 BRODICK CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-6168
Practice Address - Country:US
Practice Address - Phone:910-792-6138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC065-160322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6604096Medicaid
NC3404933Medicaid