Provider Demographics
NPI:1356521413
Name:FRANKLIN-GRANVILLE-VANCE PARTNERSHIP FOR CHILDREN
Entity type:Organization
Organization Name:FRANKLIN-GRANVILLE-VANCE PARTNERSHIP FOR CHILDREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:MALONE
Authorized Official - Last Name:PAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-433-9110
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:125 CHARLES ROLLINS ROAD
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-0142
Mailing Address - Country:US
Mailing Address - Phone:252-433-9110
Mailing Address - Fax:252-433-9230
Practice Address - Street 1:125 CHARLES ROLLINS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2946
Practice Address - Country:US
Practice Address - Phone:252-433-9110
Practice Address - Fax:252-433-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2399251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2399OtherNCBLPC