Provider Demographics
NPI:1770712333
Name:NC FAMILY SUPPORTLINK
Entity type:Organization
Organization Name:NC FAMILY SUPPORTLINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CIO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:HAMMONDS
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:704-713-1210
Mailing Address - Street 1:2923 S TRYON ST
Mailing Address - Street 2:STE 220
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5852
Mailing Address - Country:US
Mailing Address - Phone:704-713-1210
Mailing Address - Fax:704-726-7362
Practice Address - Street 1:2923 S TRYON ST
Practice Address - Street 2:STE 220
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5852
Practice Address - Country:US
Practice Address - Phone:704-713-1210
Practice Address - Fax:704-726-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-03
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health