NPI |
1497089072 |
The last name of the provider. If the provider is an individual, this is the legal name. |
Entity Type Code |
2 |
The first name of the provider, if the provider
is an individual. |
Employer Identification Number EIN |
|
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Organization Name Legal Business Name |
FAMILY ADVANCING MORE EFFECTIVELY |
The city name in the location address of the provider being identified. |
Provider First Line Business Practice Location Address |
3326 GUESS ROAD |
The State code in the location of the provider
being identified. |
Provider Second Line Business Practice Location Address |
203 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address City Name |
DURHAM |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
NC |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
277052160 |
The fax number associated with the location
address of the provider being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Business Practice Location Address Telephone Number |
9196722285 |
The date that a record was last updated or changed. |
Provider Enumeration Date |
9/29/2009 |
The code designating the provider’s gender if the provider is a person. |
Last Update Date |
9/29/2009 |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Authorized Official Last Name |
GLASS |
|
Authorized Official First Name |
STACIA |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Authorized Official Middle Name |
YVETTE |
The middle name of the authorized official. |
Authorized Official Title or Position |
CEO / DIRECTOR |
The title or position of the authorized official. |
Authorized Official Telephone Number |
9196722885 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
251S00000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider License Number State Code 1 |
NC |
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Organization Subpart |
N |
|
Authorized Official Name Prefix Text |
MS. |
|