Provider Demographics
NPI:1194912568
Name:EL ROPHE CENTER, INC
Entity type:Organization
Organization Name:EL ROPHE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COUNSELING
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LANGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-843-4818
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:116 S. PROVIDENCE ST.
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-1044
Mailing Address - Country:US
Mailing Address - Phone:704-843-4818
Mailing Address - Fax:704-843-5111
Practice Address - Street 1:116 S. PROVIDENCE ST.
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173
Practice Address - Country:US
Practice Address - Phone:704-843-4818
Practice Address - Fax:704-843-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)