Organization
CAMPBELL SECOND CHANCE RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA ANN CAMPBELL (EXECUTIVE DIRECTOR)
(910) 556-6130
Entity
Organization
Contact information
Practice address
601 TARBORO ST, ROCKY MOUNT, NC 27801-5955
(910) 556-6130
Mailing address
115 APPOMATTOX DR, CAMERON, NC 28326-5536
(910) 556-6130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
344600000X
Taxi
—
—
344800000X
Air Carrier
—
—
347B00000X
Bus
—
—
347C00000X
Private Vehicle
—
—
347D00000X
Train
—
—
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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