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
118 E. ELIZABETH STREET, CLINTON, NC 28328-4018
(910) 590-2286
(910) 592-3217
Mailing address
131 HAY STREET, SUITE 201, FAYETTEVILLE, NC 28301-5649
(910) 323-1817
(910) 323-2607
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302100
—
NC
05
—
8302100A
—
NC
05
—
8302100B
—
NC
05
—
8302100P
—
NC
05
—
8302100Q
—
NC
Enumeration date
07/17/2007
Last updated
11/10/2009
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