# MILLENNIAL SERVICES OF NC AT ROCKINGHAM

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MILLENNIAL SERVICES OF NC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1801413687
- **Legal business name:** MILLENNIAL SERVICES OF NC
- **Authorized official:** DR. RONALD FLACK JR. MA, PHD, ICADC, NCAC (OWNER)
- **Authorized official phone:** (336) 587-2931

## Contact information

- **Practice address:** 510 S TIPTON PL, REIDSVILLE, NC 27320-3039
- **Practice address phone:** (336) 587-2931
- **Mailing address:** 1520 BOWMORE PL, MC LEANSVILLE, NC 27301-9248
- **Mailing address phone:** (033) 658-7293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/29/2020
- **Last updated:** 06/29/2020