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General NPI Number Information
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NPI Number | 1619233756
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Entity Type | Organization
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Legal Business Name | RUMBAUGH FAMILY TREATMENT CENTER, LLC
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 1617B OWEN DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3425
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Country | US
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Telephone | 910-484-3330
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Fax | 910-484-3301
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Provider Business Mailing Address
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Address Line | 1617B OWEN DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3425
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Country | US
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Telephone | 910-484-3330
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Fax | 910-484-3301
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Authorized Official
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Title or Position | LCSW/PARTNER
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Name | MR. PAUL CARLETON RUMBAUGH JR.
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Credential | LCSW
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Telephone | 910-484-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C000397
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License Number State | NC
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