| Organization Name: | CRANDELL'S ENTERPRISES INC |
| NPI Number: | 1255752085 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROLYN MAYO (DIRECTOR OF SPECIAL SERVICES) |
| Mailing Address: | 7112 Outrigger Dr Wendell |
| State: | NC US |
| Postal Code: | 275917240 |
| Phone Number: | 9196260079 |
| Fax Number: | |
| NPI Enumeration Date: | 12/20/2013 |
| NPI Last Update Date: | 12/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MHL 092-882 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |