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General NPI Number Information
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NPI Number | 1447459490
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Entity Type | Organization
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Legal Business Name | OUTREACH COMMUNITY SERVICES
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 2986 CUMBERLAND RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2250
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Country | US
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Telephone | 910-424-0307
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Fax | 910-424-0307
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Provider Business Mailing Address
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Address Line | 2986 CUMBERLAND RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-2250
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Country | US
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Telephone | 910-424-0307
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Fax | 910-424-0307
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. ROBERT JOEL CAIN
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Credential | MDTH, MED, BS/QP
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Telephone | 910-823-6531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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