Provider Demographics
NPI:1508136250
Name:MELVIN MARKETING, LLC
Entity Type:Organization
Organization Name:MELVIN MARKETING, LLC
Other - Org Name:COMMUNITY SERVICES CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELVIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:910-922-1205
Mailing Address - Street 1:610 SUMMIT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7742
Mailing Address - Country:US
Mailing Address - Phone:910-922-1205
Mailing Address - Fax:
Practice Address - Street 1:610 SUMMIT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7742
Practice Address - Country:US
Practice Address - Phone:910-922-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health