Organization
STEPHENS OUTREACH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA SHEREESE MOORE LCMHCS, LCAS (CEO)
(910) 738-7865
Entity
Organization
Contact information
Practice address
405A DUNN RD, LUMBERTON, NC 28358-7913
(910) 738-7865
(910) 738-7876
Mailing address
405A DUNN RD, LUMBERTON, NC 28358-7913
(910) 738-7865
(910) 738-7876
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL078149
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604154
—
NC
05
—
8301487B
—
NC
Enumeration date
10/29/2008
Last updated
05/22/2026
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