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NPI 1992088793

NPI 1992088793 : ROUSE COUNSELING & CONSULTING SERVICES : WHITEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1992088793
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    Entity Type          |    Organization 
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    Legal Business Name  |    ROUSE COUNSELING & CONSULTING SERVICES 
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Dates
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    Enumeration Date     |    09/28/2011
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    Last Update Date     |    09/28/2011
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Provider Practice Location Address
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    Address Line         |    805 N. FRANKLIN ST 
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    City                 |    WHITEVILLE
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    State                |    NC
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    Zip                  |    28472-0707
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    Country              |    US
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    Telephone            |    910-642-9008
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    805 N. FRANKLIN ST 
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    City                 |    WHITEVILLE
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    State                |    NC
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    Zip                  |    28472-0707
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     RICKIE  ROUSE 
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    Credential           |    
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    Telephone            |    910-642-9008
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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-024-053
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    License Number State |    NC
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