Provider Demographics
NPI:1215173885
Name:PARTNERING FOR EXCELLENCE IN A NEEDY SOCIETY P.E.N.S., LLC
Entity type:Organization
Organization Name:PARTNERING FOR EXCELLENCE IN A NEEDY SOCIETY P.E.N.S., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:SHAW
Authorized Official - Last Name:MUSLIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-403-7367
Mailing Address - Street 1:3326 DURHAM CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE 120A
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6239
Mailing Address - Country:US
Mailing Address - Phone:919-403-7367
Mailing Address - Fax:919-403-7427
Practice Address - Street 1:3326 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 120A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6239
Practice Address - Country:US
Practice Address - Phone:919-403-7367
Practice Address - Fax:919-403-7427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20518101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty