Healthcare Provider Details
I. General information
NPI: 1982740312
Provider Name (Legal Business Name): RECLAMATION FAMILY SERVICES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
306 HOSPITAL DR
WINDSOR NC
27983-1602
US
IV. Provider business mailing address
103 COMMERCE ST SUITE A
GREENVILLE NC
27858-5036
US
V. Phone/Fax
- Phone: 252-209-1773
- Fax: 252-794-4616
- Phone: 252-209-1773
- Fax: 252-794-4616
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 322D00000X |
| Taxonomy | Emotionally Disturbed Childrens' Residential Treatment Facility |
| License Number | MHL008035 |
| License Number State | NC |
VIII. Authorized Official
Name: MRS.
REGINA
WILSON
PEELE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 252-209-1773