Provider Demographics
NPI:1477827962
Name:THE VILLAGE-A COMPREHENSIVE HUMAN SERVICE NETWORK
Entity Type:Organization
Organization Name:THE VILLAGE-A COMPREHENSIVE HUMAN SERVICE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:UDOFIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-697-7991
Mailing Address - Street 1:650 GANYARD FARM WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6270
Mailing Address - Country:US
Mailing Address - Phone:919-697-7991
Mailing Address - Fax:919-598-5007
Practice Address - Street 1:650 GANYARD FARM WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-6270
Practice Address - Country:US
Practice Address - Phone:919-697-7991
Practice Address - Fax:919-598-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management