Stephens Outreach Center, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STEPHENS OUTREACH CENTER, INC

Practice address

105 W 5TH St
Tabor City, NC 28463-1923

Phone

(910) 653-5553

NPI assigned

Dec 22, 2008

Last updated

Dec 22, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Melvin J Stephens Sr.

Title

Ceo

Phone

(910) 308-4847

Specialties & licenses 3

Addresses

Other identifiers 3

Tax ID family

Stephens Outreach Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Stephens Outreach Center, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fairmont, NC
  • NPI 1033252440
  NPD tax ID
• Stephens Outreach Center, Inc

  • Clinic Pharmacy
  • Fairmont, NC
  • NPI 1043093339
  NPD tax ID
• Stephens Outreach Center, Inc

  • Community/Behavioral Health Agency
  • Lumberton, NC
  • NPI 1164668414
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229904000000",
    "number": "1790921716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W 5TH ST",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284631923",
            "telephone_number": "910-653-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 5TH ST",
            "city": "TABOR CITY",
            "state": "NC",
            "postal_code": "284631923",
            "telephone_number": "910-653-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENS OUTREACH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2008-12-22",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-308-4847",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL078149",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006568",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301487B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604154",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rinda Jo Smith, LSW, LCSWA
• Brittany Renee Sykes, PHARMD
• Tabor City Emergency Services Inc.
• Tabor City Family Medical Clinic, PC
• Tabor City Family Medicine Center, Inc.
• Tabor City Medicine Mart, Inc

• Community/Behavioral Health Agency in Tabor City, NC
• Providers in Tabor City, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.