MAKING A DIFFERENCE COMMUNITY SUPPORT LLC
Ambulatory Health in Fort Raleigh City, NC

License number
North Carolina 261QM0850X
Category
Ambulatory Health
Type
Adult Mental Health
License number
North Carolina 261QM0855X
Category
Ambulatory Health
Type
Adolescent and Children Mental Health
License number
North Carolina 261QR0400X
Category
Ambulatory Health
Type
Rehabilitation
Owner
Name: SHANEQUA CORNISE BENTON
Title: MEMBER/ORGANIZER
Phone: (252) 475-9829
Address
Address 2
102 Old Tom Ave., Fort Raleigh City, NC 27954
PO Box 7672, Kill Devil Hills, NC 27948
National Provider ID: 1912186735
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Ambulatory Health licenses in North Carolina

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