Provider Demographics
NPI:1295974525
Name:FAMILY CONNECTIONS OF GREENVILLE, LLC
Entity type:Organization
Organization Name:FAMILY CONNECTIONS OF GREENVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-916-4050
Mailing Address - Street 1:704 PLAZA BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1557
Mailing Address - Country:US
Mailing Address - Phone:252-520-4607
Mailing Address - Fax:252-520-4593
Practice Address - Street 1:704 PLAZA BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1557
Practice Address - Country:US
Practice Address - Phone:252-520-4607
Practice Address - Fax:252-520-4593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health