Provider Demographics
NPI:1740597608
Name:FACT SPECIALIZED SERVICES, INC.
Entity Type:Organization
Organization Name:FACT SPECIALIZED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:ASCHBRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-346-3744
Mailing Address - Street 1:127 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5708
Mailing Address - Country:US
Mailing Address - Phone:910-346-3744
Mailing Address - Fax:910-346-5344
Practice Address - Street 1:127 CENTER ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5708
Practice Address - Country:US
Practice Address - Phone:910-346-3744
Practice Address - Fax:910-346-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2112103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty