Provider Demographics
NPI:1417269101
Name:MOV'N FORWARD, INCORPORATED
Entity Type:Organization
Organization Name:MOV'N FORWARD, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SWAMNELLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-412-3253
Mailing Address - Street 1:4490 BOYDS RD
Mailing Address - Street 2:
Mailing Address - City:GRIMESLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27837-8931
Mailing Address - Country:US
Mailing Address - Phone:252-412-3253
Mailing Address - Fax:973-230-4378
Practice Address - Street 1:607 MERRICK ST SE
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-6443
Practice Address - Country:US
Practice Address - Phone:252-412-3253
Practice Address - Fax:973-230-4378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health