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Organization
STEPHENS OUTREACH CENTER, INC
Active
Organization
STEPHENS OUTREACH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELVIN J STEPHENS (CEO)
(910) 738-7865
Entity
Organization
Contact information
Practice address
2105B ELIZABETHTOWN ROAD, LUMBERTON, NC 28358-3107
(910) 738-7865
Mailing address
PO BOX 1462, FAIRMONT, NC 28340-1110
(910) 738-7865
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL078149
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604154
—
NC
05
—
8301487
—
NC
Enumeration date
12/16/2008
Last updated
12/16/2008
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