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Organization
PROGRAM RESOURCE INSTITUTE
Active
Organization
PROGRAM RESOURCE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TED FITZGERALD M.S. (EXECUTIVE DIRECTOR)
(910) 891-7062
Entity
Organization
Contact information
Practice address
1505 US HIGHWAY 1 S, SOUTHERN PINES, NC 28387-7036
(910) 693-2641
(910) 692-3489
Mailing address
108 N ORANGE AVE, DUNN, NC 28334-3826
(910) 891-7062
(910) 892-3764
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MHL-063-075
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
MHL-063-075
NC
101YM0800X
Mental Health Counselor
MHL063-075
NC
251S00000X
Community/Behavioral Health Agency
Primary
MHL-063-075
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301954
—
NC
Enumeration date
03/09/2007
Last updated
01/15/2009
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