Organization
SOUTHEASTERN REGIONAL MEDICAL CENTER
Active
Other names
Community Alternatives Program for Disabled Adults of Robeson County
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C. THOMAS JOHNSON III CPA (V. P. FINANCE)
(910) 671-5090
Entity
Organization
Contact information
Practice address
4308 LUDGATE ST, LUMBERTON, NC 28358-2461
(910) 671-5185
Mailing address
2600 N ELM ST, LUMBERTON, NC 28358-3011
(910) 671-5733
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
251B00000X
Case Management Agency
Primary
H0064
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408280
—
NC
Enumeration date
11/17/2005
Last updated
01/24/2014
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