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Organization

PETERKIN AND ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ALICE D. SMITH ED.D (EXECUTIVE DIRECTOR)
(910) 323-1817
Entity
Organization

Contact information

Practice address
128 W. 5TH STREET, LUMBERTON, NC 28358-5539
(910) 738-3999
(910) 738-3400
Mailing address
131 HAY STREET, SUITE 201, FAYETTEVILLE, NC 28301-5649
(910) 323-1817
(910) 323-2607

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
NC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
NC
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
320800000X
Mental Illness Community Based Residential Treatment Facility
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
324500000X
Substance Abuse Rehabilitation Facility
NC
324500000X
Substance Abuse Rehabilitation Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8302017
NC
05
8302017A
NC
05
8302017B
NC
05
8302017G
NC
Enumeration date
04/25/2007
Last updated
11/10/2009
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