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Organization

PETERKIN AND ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALICE D. SMITH ED.D. (EXECUTIVE DIRECTOR)
(910) 323-1817
Entity
Organization

Contact information

Practice address
131 HAY ST., SUITE 201, FAYETTEVILLE, NC 28301-5649
(910) 323-1817
(910) 323-2607
Mailing address
131 HAY ST., SUITE 201, FAYETTEVILLE, NC 28301-5649
(910) 323-1817
(910) 323-2607

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-026-017
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-026-049
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-026-071
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-026-097
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-063-016
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-063-017
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8300766
NC
Enumeration date
10/05/2006
Last updated
07/12/2010
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