Provider Demographics
NPI:1154509529
Name:ROCKINGHAM COUNTY SCHOOLS DAY TREATMENT PROGRAM
Entity type:Organization
Organization Name:ROCKINGHAM COUNTY SCHOOLS DAY TREATMENT PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELL
Authorized Official - Middle Name:HOOPER
Authorized Official - Last Name:BARBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-634-3209
Mailing Address - Street 1:401 MOSS ST
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-3439
Mailing Address - Country:US
Mailing Address - Phone:336-634-3209
Mailing Address - Fax:336-634-3260
Practice Address - Street 1:401 MOSS ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-3439
Practice Address - Country:US
Practice Address - Phone:336-634-3209
Practice Address - Fax:336-634-3260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-079-091251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8600000Medicaid
NC1619045275OtherNPI