Healthcare Provider Details

I. General information

NPI: 1730007899
Provider Name (Legal Business Name): ASCEND INTEGRATED CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 WEST THIRD STREET
PEMBROKE NC
28372
US

IV. Provider business mailing address

405 WEST THIRD STREET
PEMBROKE NC
28372
US

V. Phone/Fax

Practice location:
  • Phone: 910-734-3054
  • Fax:
Mailing address:
  • Phone: 910-734-3054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: DEMETRUS LOCKLEAR
Title or Position: CHIEF OF OPERATIONS
Credential: MBA
Phone: 910-734-7824