Provider Demographics
NPI:1225191240
Name:WE CARE RESIDENTIAL FACILITY
Entity Type:Organization
Organization Name:WE CARE RESIDENTIAL FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-830-9600
Mailing Address - Street 1:1761 ROOSEVELT SPAIN ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7340
Mailing Address - Country:US
Mailing Address - Phone:252-329-8813
Mailing Address - Fax:252-329-9460
Practice Address - Street 1:1761 ROOSEVELT SPAIN ROAD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7340
Practice Address - Country:US
Practice Address - Phone:252-329-8813
Practice Address - Fax:252-329-9460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL074130322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children