Provider Demographics
NPI:1699407338
Name:ARCHWAY CHILD AND FAMILY CARE
Entity Type:Organization
Organization Name:ARCHWAY CHILD AND FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:DOMINGUEZ
Authorized Official - Last Name:CRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LCSW,RPT
Authorized Official - Phone:410-693-8966
Mailing Address - Street 1:201 SCHOOL DR STE D
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-6330
Mailing Address - Country:US
Mailing Address - Phone:336-475-1362
Mailing Address - Fax:336-475-1363
Practice Address - Street 1:201 SCHOOL DR STE D
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-6330
Practice Address - Country:US
Practice Address - Phone:336-475-1362
Practice Address - Fax:336-475-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty