Provider Demographics
NPI:1851674394
Name:ROBESON COUNTY OFFENDER RESOURCE CENTER
Entity Type:Organization
Organization Name:ROBESON COUNTY OFFENDER RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CSAC
Authorized Official - Phone:910-737-5022
Mailing Address - Street 1:120 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-5541
Mailing Address - Country:US
Mailing Address - Phone:910-737-5022
Mailing Address - Fax:910-737-5051
Practice Address - Street 1:120 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5541
Practice Address - Country:US
Practice Address - Phone:910-737-5022
Practice Address - Fax:910-737-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-078-119324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility