Provider Demographics
NPI:1609931120
Name:MIDDLE TRACK UNITED FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:MIDDLE TRACK UNITED FAMILY SERVICES, INC.
Other - Org Name:MIDDLE TRACK UNITED FAMILY SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:RAZOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-794-1555
Mailing Address - Street 1:925 MIDDLE TRACT RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-8933
Mailing Address - Country:US
Mailing Address - Phone:252-794-1555
Mailing Address - Fax:252-794-1556
Practice Address - Street 1:925 MIDDLE TRACT RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-8933
Practice Address - Country:US
Practice Address - Phone:252-794-1555
Practice Address - Fax:252-794-1556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-008-026322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children