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General NPI Number Information
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NPI Number | 1700017761
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Entity Type | Organization
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Legal Business Name | ARLEE ARMS TREATMENT CENTER
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Dates
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Enumeration Date | 08/07/2009
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Last Update Date | 08/07/2009
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Provider Practice Location Address
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Address Line | 309 GOUGH ST
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City | PEMBROKE
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State | NC
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Zip | 28372-9660
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Country | US
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Telephone | 910-258-2134
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Fax | 910-521-0710
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Provider Business Mailing Address
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Address Line | 309 GOUGH ST
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City | PEMBROKE
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State | NC
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Zip | 28372-9660
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Country | US
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Telephone | 910-258-2134
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Fax | 910-521-0710
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | JANET HUNT BASS
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Credential |
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Telephone | 910-258-2134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | MHL-078-230
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License Number State | NC
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