Basic Information
| Provider Information | |||||||||
| NPI: | 1063650984 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FAMILIES TOGETHER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 S JOHNSON ST | ||||||||
| Address2: | |||||||||
| City: | BREVARD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287123707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282580031 | ||||||||
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| Practice Location | |||||||||
| Address1: | 107 S JOHNSON ST | ||||||||
| Address2: | |||||||||
| City: | BREVARD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287123707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282580031 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2009 | ||||||||
| LastUpdateDate: | 01/30/2009 | ||||||||
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| AuthorizedOfficialLastName: | PROFFITT | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | REIMBURSEMENT SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 8282580031 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 8302292B | 05 | NC | MEDICAID |