Provider Demographics
NPI:1821294471
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:HENRY
Authorized Official - Last Name:RAZOR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-794-1555
Mailing Address - Street 1:119 E GRANVILLE ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-1230
Mailing Address - Country:US
Mailing Address - Phone:252-794-1555
Mailing Address - Fax:252-794-1556
Practice Address - Street 1:119 E GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-1230
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:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health