Organization
PETERKIN & ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICE SMITH ED.D (CEO)
(910) 323-1817
Entity
Organization
Contact information
Practice address
114 GREENHOUSE LN, SOUTHERN PINES, NC 28387-3140
(910) 323-1817
Mailing address
131 HAY ST STE 201, FAYETTEVILLE, NC 28301-5649
(910) 323-1817
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
MHL-063-017
NC
310500000X
Mental Illness Intermediate Care Facility
MHL-063-017
NC
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-063-017
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-063-017
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340604W
—
NC
Enumeration date
03/06/2007
Last updated
01/11/2012
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