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General NPI Number Information
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NPI Number | 1831900521
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Entity Type | Organization
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Legal Business Name | KENNETH SAMUDA COUNSELING SERVICES
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 13180 GASTON AVE
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City | LAURINBURG
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State | NC
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Zip | 28352-5952
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Country | US
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Telephone | 910-318-2176
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Fax |
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Provider Business Mailing Address
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Address Line | 13180 GASTON AVE
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City | LAURINBURG
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State | NC
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Zip | 28352-5952
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Country | US
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Telephone | 910-318-2176
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. KENNETH E SAMUDA
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Credential | CADC
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Telephone | 910-318-2176
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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 |
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License Number State |
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