Organization
CHILDREN'S HEALTH OF CAROLINA DBA PEMBROKE PEDIATRICS MENTAL HEALTH
Active
Parent organization
CHILDREN'S HEALTH OF CAROLINA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HEALTH OF CAROLINA
Authorized official
ROSE DUCKWORTH (COMPLIANCE OFFICER)
(910) 738-8060
Entity
Organization
Contact information
Practice address
400 LIBERTY HILL RD, LUMBERTON, NC 28358-2446
(910) 738-8060
(910) 671-3600
Mailing address
812 CANDY PARK RD, PEMBROKE, NC 28372-9129
(910) 521-0201
(910) 521-0773
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890253U
—
NC
Enumeration date
09/06/2007
Last updated
09/06/2007
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