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General NPI Number Information
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NPI Number | 1013183680
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Entity Type | Organization
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Legal Business Name | ASSOCIATE BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 206 E. 7TH STREET
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City | LUMBERTON
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State | NC
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Zip | 28358
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Country | US
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Telephone | 910-735-0556
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Fax | 910-735-0556
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Provider Business Mailing Address
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Address Line | PO BOX 920
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City | LUMBERTON
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State | NC
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Zip | 28359-0920
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Country | US
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Telephone | 910-735-0556
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Fax | 910-735-0557
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. GREGORY MOORE
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Credential | MA
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Telephone | 910-735-0556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | NC
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