Healthcare Provider Details

I. General information

NPI: 1609702281
Provider Name (Legal Business Name): NORTH CAROLINA RECOVERY NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2792 QUINN SAWMILL RD
PINK HILL NC
28572-9523
US

IV. Provider business mailing address

PO BOX 211
PINK HILL NC
28572-0211
US

V. Phone/Fax

Practice location:
  • Phone: 910-320-4688
  • Fax:
Mailing address:
  • Phone: 910-320-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHANNON ROUSE RUIZ
Title or Position: OWNER
Credential:
Phone: 910-320-4688