Provider Demographics
NPI:1427338045
Name:TREE OF COMPASSION OUTREACH RESOURCE CENTER, LLC
Entity type:Organization
Organization Name:TREE OF COMPASSION OUTREACH RESOURCE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:E. JEAN
Authorized Official - Middle Name:HERNDON
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN IN COUNSELING
Authorized Official - Phone:919-237-3430
Mailing Address - Street 1:PO BOX 2894
Mailing Address - Street 2:5842 FAYETTVILLE RD SUITE 215
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27715-2894
Mailing Address - Country:US
Mailing Address - Phone:919-697-8083
Mailing Address - Fax:919-287-2332
Practice Address - Street 1:5842 FAYETTEVILLE RD
Practice Address - Street 2:SUITE 215
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6295
Practice Address - Country:US
Practice Address - Phone:919-697-8083
Practice Address - Fax:919-287-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty