Healthcare Provider Details

I. General information

NPI: 1689774861
Provider Name (Legal Business Name): PROGRAM RESOURCE INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N PINE ST
ABERDEEN NC
28315-2732
US

IV. Provider business mailing address

108 N ORANGE AVE
DUNN NC
28334-3826
US

V. Phone/Fax

Practice location:
  • Phone: 910-944-2189
  • Fax: 910-944-7443
Mailing address:
  • Phone: 910-891-7062
  • Fax: 910-892-3764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLPC - 2870
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License NumberMHL-076-082
License Number StateNC

VIII. Authorized Official

Name: MR. TED FITZGERALD
Title or Position: EXECUTIVE DIRECTOR
Credential: M.S.
Phone: 910-891-7062