Provider Demographics
NPI:1346394814
Name:TAFT'S CREATIVE SERVICE COUNCIL, INC.
Entity Type:Organization
Organization Name:TAFT'S CREATIVE SERVICE COUNCIL, INC.
Other - Org Name:BARBIE'S AND LEACH'S FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-630-1946
Mailing Address - Street 1:PO BOX 43207
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-3207
Mailing Address - Country:US
Mailing Address - Phone:910-630-1946
Mailing Address - Fax:910-482-0298
Practice Address - Street 1:413 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-7601
Practice Address - Country:US
Practice Address - Phone:910-630-1946
Practice Address - Fax:910-482-0298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL 026 017261QD1600X
NCFCL 026 037261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities