Healthcare Provider Details

I. General information

NPI: 1548633555
Provider Name (Legal Business Name): LUMBERTON TREATMENT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 CLYBORN CHURCH RD
LUMBERTON NC
28360-9356
US

IV. Provider business mailing address

1112 SILVER OAKS CT
RALEIGH NC
27614-9359
US

V. Phone/Fax

Practice location:
  • Phone: 910-739-9160
  • Fax: 910-739-9155
Mailing address:
  • Phone: 919-656-1633
  • Fax: 919-706-5158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MACY HAMM
Title or Position: CEO
Credential: J.D.
Phone: 919-656-1633