Southeast Community Outreach LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHEAST COMMUNITY OUTREACH LLC

Practice address

206 Enterprise St
Chadbourn, NC 28431-2104

Phone

(919) 824-6339

Fax

(800) 595-4571

NPI assigned

Apr 23, 2010

Last updated

Apr 23, 2010By 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

Theric Holt, B.S., QP

Title

Executive Director

Phone

(919) 824-6339

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1871810341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284720161",
            "telephone_number": "919-824-6339",
            "fax_number": "800-595-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 ENTERPRISE ST",
            "city": "CHADBOURN",
            "state": "NC",
            "postal_code": "284312104",
            "telephone_number": "919-824-6339",
            "fax_number": "800-595-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST COMMUNITY OUTREACH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "THERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-824-6339",
        "authorized_official_credential": "B.S., QP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Chadbourn, NC
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• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.