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NPI 1245360387 · Mental Illness Community Based Residential Treatment Facility · Stantonsburg, NC
Provider details
- NPI number
- 1245360387
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Thomas Mccollum, Ceo(252) 747-4000
- License
- MHL040026 (NC)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense MHL040026 (NC)
Residential Treatment Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1233 Appletree Road
Stantonsburg, NC 27833
Phone: (252) 747-4000
Fax: (252) 747-2602
Street-level locationGet directions
Mailing address
Po Box 295
Snow Hill, NC 28580-0295
Registry dates
- Enumerated
- 2007-03-07
- Last updated
- 2008-01-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.