Healthcare Provider Details

I. General information

NPI: 1659493344
Provider Name (Legal Business Name): ROCKINGHAM OPPORTUNITIES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 CHEROKEE CAMP RD
REIDSVILLE NC
27320
US

IV. Provider business mailing address

342 CHEROKEE CAMP RD
REIDSVILLE NC
27320
US

V. Phone/Fax

Practice location:
  • Phone: 336-342-4761
  • Fax: 336-342-0310
Mailing address:
  • Phone:
  • Fax: 336-342-0310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberMHL079005
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL079026
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL079027
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL079032
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL079029
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL079034
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberMHL079035
License Number StateNC

VIII. Authorized Official

Name: JEFFREY E PRUETT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 336-342-4761