Provider Demographics
NPI:1992961163
Name:ENRICHMENT BEHAVIORAL CARE SERVICES, LLC
Entity type:Organization
Organization Name:ENRICHMENT BEHAVIORAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RELONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-217-0363
Mailing Address - Street 1:102 S 1ST AVE
Mailing Address - Street 2:STE 6
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7055
Mailing Address - Country:US
Mailing Address - Phone:919-217-0363
Mailing Address - Fax:919-217-0365
Practice Address - Street 1:102 S 1ST AVE
Practice Address - Street 2:STE 6
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7055
Practice Address - Country:US
Practice Address - Phone:919-217-0363
Practice Address - Fax:919-217-0365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty