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General NPI Number Information
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NPI Number | 1770319840
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Entity Type | Organization
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Legal Business Name | COMING HOME TO NEW BEGINNINGS
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1310 RAEFORD RD STE 1
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5086
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Country | US
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Telephone | 301-378-6342
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Fax |
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Provider Business Mailing Address
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Address Line | 2808 DEEPWATER CT
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-8180
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Country | US
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Telephone | 301-378-6342
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | EBONE ROCKER
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Credential | LCMHCS
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Telephone | 301-378-6342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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