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STEPHENS OUTREACH CENTER INC NPI 1790921716


NPI Information

NPI: 1790921716
Provider Name: STEPHENS OUTREACH CENTER, INC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
105 W 5TH ST
TABOR CITY, NC
ZIP 28463
Phone: (910) 653-5553
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STEPHENS OUTREACH CENTER, INC is a community behavioral health in Tabor City, NC. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. STEPHENS OUTREACH CENTER, INC NPI is 1790921716. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

105 W 5TH ST
TABOR CITY, NC
ZIP 28463-923
Phone: (910) 653-5553

The provider's authorized official is Melvin J Stephens .
The authorized official title is Ceo and has the following contact phone number (910) 308-4847.

The enumeration date for this NPI number is 12/22/2008 and was last updated on 12/22/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL078149NORTH CAROLINANo
3251S00000XCommunity/Behavioral HealthNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18301487BMEDICAIDNORTH CAROLINA
26604154MEDICAIDNORTH CAROLINA
36006568MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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