Healthcare Provider Details

I. General information

NPI: 1558319251
Provider Name (Legal Business Name): SELF CARE THERAPY INCORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6626 GORDON RD SUITE H
WILMINGTON NC
28411-8423
US

IV. Provider business mailing address

6626 GORDON RD STE H
WILMINGTON NC
28411-8424
US

V. Phone/Fax

Practice location:
  • Phone: 910-233-0730
  • Fax:
Mailing address:
  • Phone: 910-233-0730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4588
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ROBERT P W ERKSTAM
Title or Position: OWNER / OCCUPATIONAL THERAPIST
Credential: OTR
Phone: 910-233-0730