Organization
ELITE CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES FREDERICK (CEO)
(910) 483-0324
Entity
Organization
Contact information
Practice address
111 LAMON ST, SUITE 100, FAYETTEVILLE, NC 28301-4901
(910) 483-0324
(910) 483-2246
Mailing address
111 LAMON ST STE 100, FAYETTEVILLE, NC 28301-4917
(910) 483-0324
(910) 483-2246
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
222Q00000X
Developmental Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL-026-857
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112912
—
NC
Enumeration date
01/31/2008
Last updated
07/22/2026
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