Provider Demographics
NPI:1669611539
Name:CAPTURING HEARTS COMMUNITY SERVICES
Entity type:Organization
Organization Name:CAPTURING HEARTS COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHENIQUE
Authorized Official - Middle Name:NANETTE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-344-2803
Mailing Address - Street 1:200 W ASH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-3657
Mailing Address - Country:US
Mailing Address - Phone:919-344-2803
Mailing Address - Fax:
Practice Address - Street 1:200 W ASH ST STE 104
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-3657
Practice Address - Country:US
Practice Address - Phone:919-344-2803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health