Provider Demographics
NPI:1639225113
Name:NATURE'S REFLECTIONS, LLC
Entity Type:Organization
Organization Name:NATURE'S REFLECTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:QUANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-477-2728
Mailing Address - Street 1:1007 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4143
Mailing Address - Country:US
Mailing Address - Phone:919-477-2728
Mailing Address - Fax:919-477-3938
Practice Address - Street 1:1007 BROAD ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4143
Practice Address - Country:US
Practice Address - Phone:919-477-2728
Practice Address - Fax:919-477-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301329Medicaid
NC8301329VMedicaid
NC3410182Medicaid
NC8301329SMedicaid
NC8301329HMedicaid
NC6008106Medicaid
NC8301329BMedicaid
NC5915112Medicaid
NC8301329GMedicaid