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General NPI Number Information
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NPI Number | 1154494821
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Entity Type | Organization
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Legal Business Name | ASSOCIATE BEHAVIORAL SERVICES, INC.
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 325 E 4TH ST
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City | LUMBERTON
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State | NC
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Zip | 28358-5526
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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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Provider Business Mailing Address
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Address Line | 325 E 4TH ST
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City | LUMBERTON
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State | NC
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Zip | 28358-5526
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MHL-078-161
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHL-078-161
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License Number State | NC
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