Organization
ARTHUR FENNER OUTREACH CENTER LLC
Active
Other names
Arthur Fenner Outreach Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LEE GREEN (PEER SUPPORT SPECIALIST)
(252) 676-5701
Entity
Organization
Contact information
Practice address
1423 MARSHALL ST, ROANOKE RAPIDS, NC 27870-4413
(252) 541-1235
(252) 541-1111
Mailing address
1423 MARSHALL ST, ROANOKE RAPIDS, NC 27870-4413
(252) 676-5701
(252) 541-1111
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5005077
—
NC
Enumeration date
10/20/2022
Last updated
06/07/2025
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