Provider Demographics
NPI:1487217097
Name:FAMILY PRESERVATION SERVICES OF NC, LLC-ROC
Entity Type:Organization
Organization Name:FAMILY PRESERVATION SERVICES OF NC, LLC-ROC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATE BUSINESS ANALYST & CONTRACTS
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FREELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-344-0491
Mailing Address - Street 1:2300 SARDIS RD N STE M
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7712
Mailing Address - Country:US
Mailing Address - Phone:704-344-0491
Mailing Address - Fax:704-344-0493
Practice Address - Street 1:140 OLD CAROLEEN RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3749
Practice Address - Country:US
Practice Address - Phone:828-287-7945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY PRESERVATION SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health