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Organization
SOUL SHINE CHILDREN'S TREATMENT SERVICES, INC.
Active
Organization
SOUL SHINE CHILDREN'S TREATMENT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESHIA ROGERS DEESE LCSW (OWNER)
(910) 536-6094
Entity
Organization
Contact information
Practice address
218 E 2ND AVE, RED SPRINGS, NC 28377-1308
(910) 536-6094
(910) 843-9728
Mailing address
PO BOX 1546, PEMBROKE, NC 28372-1546
(910) 536-6094
(910) 843-9728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-21969
NC
1041C0700X
Clinical Social Worker
Primary
C005175
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6106174
—
NC
Enumeration date
05/09/2007
Last updated
07/09/2015
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