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NPI 1720582588

NPI 1720582588 : GLOBAL OUTREACH TELEREHABILITATION : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1720582588
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    Entity Type          |    Organization 
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    Legal Business Name  |    GLOBAL OUTREACH TELEREHABILITATION 
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Dates
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    Enumeration Date     |    03/19/2018
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    Last Update Date     |    12/16/2025
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Provider Practice Location Address
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    Address Line         |    214 FAIRWAY DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28305-5502
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    Country              |    US
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    Telephone            |    910-491-8186
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    Fax                  |    910-808-1042
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Provider Business Mailing Address
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    Address Line         |    214 FAIRWAY DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28305-5502
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    Country              |    US
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    Telephone            |    910-491-1901
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    Fax                  |    910-221-8294
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ROSALIND  WOODS 
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    Credential           |    
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    Telephone            |    910-491-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    L004636
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    License Number State |    NC
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Taxonomy #2
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    22354
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    License Number State |    NC
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Taxonomy #3
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    1-17-27316
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    License Number State |    NC
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Taxonomy #4
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    C010212
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    License Number State |    NC
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