| San Ventures | |
|
110 Fallenwood Ave Durham NC 27713-7112 | |
| (919) 491-6759 | |
| Not Available |
| Full Name | San Ventures |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 110 Fallenwood Ave, Durham, North Carolina |
| Authorized Official Name and Position | Latoshia Johnson (CEO) |
| Authorized Official Contact | 9194916759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Ventures 110 Fallenwood Ave Durham NC 27713-7112 Ph: (919) 491-6759 | San Ventures 110 Fallenwood Ave Durham NC 27713-7112 Ph: (919) 491-6759 |
| NPI Number | 1114639168 |
|---|---|
| Provider Enumeration Date | 12/21/2022 |
| Last Update Date | 12/21/2022 |
| Certification Date | 12/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114639168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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