Provider Demographics
NPI:1770611402
Name:THERAPEUTIC SOLUTIONS OF NORTH CAROLINA, LLC
Entity type:Organization
Organization Name:THERAPEUTIC SOLUTIONS OF NORTH CAROLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TOMEICO
Authorized Official - Middle Name:
Authorized Official - Last Name:FAISON
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:919-451-0313
Mailing Address - Street 1:1201 AVERSBORO RD STE H201
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4395
Mailing Address - Country:US
Mailing Address - Phone:919-451-0313
Mailing Address - Fax:
Practice Address - Street 1:1201 AVERSBORO RD STE H201
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-4395
Practice Address - Country:US
Practice Address - Phone:919-451-0313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
NC4761225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty