Provider Demographics
NPI:1770718983
Name:HEBRON CENTER FOR COUNSELING AND RECOVERY
Entity type:Organization
Organization Name:HEBRON CENTER FOR COUNSELING AND RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:704-975-9920
Mailing Address - Street 1:PO BOX 681513
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-0027
Mailing Address - Country:US
Mailing Address - Phone:704-975-9920
Mailing Address - Fax:704-875-9438
Practice Address - Street 1:10225 HICKORYWOOD HILL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3430
Practice Address - Country:US
Practice Address - Phone:704-975-9920
Practice Address - Fax:704-875-9438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)