Provider Demographics
NPI:1578899175
Name:ONE VILLAGE ONE WORLD ENHANCED SERVICES, LLC
Entity Type:Organization
Organization Name:ONE VILLAGE ONE WORLD ENHANCED SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AKIBA
Authorized Official - Middle Name:HAUSSON
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, QMHP
Authorized Official - Phone:919-940-0050
Mailing Address - Street 1:PO BOX 14254
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27620-4254
Mailing Address - Country:US
Mailing Address - Phone:919-940-0050
Mailing Address - Fax:
Practice Address - Street 1:2949 NEW BERN AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1248
Practice Address - Country:US
Practice Address - Phone:919-940-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health