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• 21 <br /> State of North Carolina <br /> Division of Social Services <br /> Contract Application Page 2 of fl <br /> E. Contract Identification: • <br /> 1 . Provider <br /> a. Name of Contract Administrator Ted Abernathy <br /> Tel. i/: (919) 732-8181 Ext 2326 <br /> b. Name of Program Contact Person: Ted Abernathy <br /> Tel if: <br /> c. Program Name, Location and Mailing Address: <br /> 110 E. King St. <br /> P.O. Box 1177, Hillsborough, NC 27278 <br /> d. Additional Service Delivery Sites: none <br /> e. Status: Qcl Public ( ) Private, non-profit <br /> ( ) Private, for profit ( ) Individual <br /> f. Provider Contract ID 1/: M 68178 <br /> 2. County Department of Social Services <br /> a. Name of Contract Administrator: Martha Pryor-Cook <br /> Tel. x/:(819) 732-8181 Ext 2802 <br /> b. Name of Services Program Contact Person: Gwendolyn Price <br /> Tel. #: (919) 732-8181 Ext 2847 <br /> c. Address of County Department of Social Services: <br /> P. 0. Box 8181 <br /> Hillsborough, NC 27278 <br /> DSS-1292 (4/87) <br /> Family Services <br />