Basic Information
| Provider Information | |||||||||
| NPI: | 1396862736 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TURNING POINT FAMILY CARE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 58496 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276588496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194930959 | ||||||||
| FaxNumber: | 9194930970 | ||||||||
| Practice Location | |||||||||
| Address1: | 3209 YORKTOWN AVE STE 172 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277135417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198967536 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2007 | ||||||||
| LastUpdateDate: | 11/01/2018 | ||||||||
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| AuthorizedOfficialLastName: | DOCKERY | ||||||||
| AuthorizedOfficialFirstName: | AMANDA | ||||||||
| AuthorizedOfficialMiddleName: | NICOLE | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 8288370071 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health | 251B00000X | N | Agencies | Case Management | 251S00000X | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 6006172 | 05 | NC | MEDICAID | 8301983R | 05 | NC | MEDICAID | 8301983B | 05 | NC | MEDICAID | 8301893 | 05 | NC | MEDICAID |