Healthcare Provider Details

I. General information

NPI: 1699032276
Provider Name (Legal Business Name): ROBESON HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 BURNS RD
LUMBERTON NC
28358
US

IV. Provider business mailing address

60 COMMERCE PLZ
PEMBROKE NC
28372-7386
US

V. Phone/Fax

Practice location:
  • Phone: 910-738-5545
  • Fax: 910-738-5565
Mailing address:
  • Phone: 910-521-2900
  • Fax: 910-775-9165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: GEORGE TIMOTHY HALL
Title or Position: PRESIDENT/CEO
Credential:
Phone: 910-521-2900