Provider Demographics
NPI:1912054594
Name:UNITY & LOVE FELLOWSHIP MINISTRIES, INC
Entity Type:Organization
Organization Name:UNITY & LOVE FELLOWSHIP MINISTRIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-321-2294
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702-0355
Mailing Address - Country:US
Mailing Address - Phone:919-321-2294
Mailing Address - Fax:919-321-1346
Practice Address - Street 1:5 JENEE LN
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2563
Practice Address - Country:US
Practice Address - Phone:919-321-2294
Practice Address - Fax:919-321-1346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL032330322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCDON'T HAVE NUMBER YEMedicaid