Provider Demographics
NPI:1295977189
Name:FAFLI INC
Entity type:Organization
Organization Name:FAFLI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:IGWILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-405-8556
Mailing Address - Street 1:1801 N TRYON STREET
Mailing Address - Street 2:SUITE B-313
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2789
Mailing Address - Country:US
Mailing Address - Phone:704-405-8556
Mailing Address - Fax:
Practice Address - Street 1:1801 N TRYON STREET
Practice Address - Street 2:SUITE B-313
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2789
Practice Address - Country:US
Practice Address - Phone:704-405-8556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC168760251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health