Provider Demographics
NPI:1831420579
Name:BEHAVIOR & COUNSELING ASSISTANCE PROGRAM
Entity type:Organization
Organization Name:BEHAVIOR & COUNSELING ASSISTANCE PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEMEAK
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-229-3597
Mailing Address - Street 1:201 S MCPHERSON CHURCH RD STE 209
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4989
Mailing Address - Country:US
Mailing Address - Phone:910-229-3597
Mailing Address - Fax:
Practice Address - Street 1:201 S MCPHERSON CHURCH RD STE 209
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4989
Practice Address - Country:US
Practice Address - Phone:910-229-3597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health