Provider Demographics
NPI:1174699334
Name:ASSOCIATES FOR FAMILY ENRICHMENT, INC
Entity type:Organization
Organization Name:ASSOCIATES FOR FAMILY ENRICHMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,ACSW,MSSW
Authorized Official - Phone:910-829-0443
Mailing Address - Street 1:3406 BOONE TRL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-2138
Mailing Address - Country:US
Mailing Address - Phone:910-829-0443
Mailing Address - Fax:910-829-0446
Practice Address - Street 1:3406 BOONE TRL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-2138
Practice Address - Country:US
Practice Address - Phone:910-829-0443
Practice Address - Fax:910-829-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5611923162OtherPROV TAX ID
NC6003803Medicaid
NC6003803Medicaid