FULL POTENTIAL AT PEMBROKE
NPI 1083747828
Community Based Residential Treatment Facility, Mental Illness in Lumberton, NC

Active since March 13, 2007
177 CARDINAL AVE, LUMBERTON, NC 28360(910) 670-1989 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Full Potential At Pembroke NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FULL POTENTIAL AT PEMBROKE (NPI 1083747828) is a healthcare organization registered as a community based residential treatment facility, mental illness in Lumberton, North Carolina and active in the NPI registry since March 2007. The organization lists Jerome Johnson, Director, as its authorized official.

NPPES Registry Identity

NPI1083747828
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameFULL POTENTIAL, LLC
Location Address177 CARDINAL AVELumberton, NC 28360-9386
Mailing Address177 Cardinal AveLumberton, NC 28360-9386
Organization SubpartNo
Authorized OfficialJerome JohnsonDirector · (910) 670-1989
Enumeration DateMarch 13, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1083747828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
License Licensed in NC · MHL-078-188
Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

177 CARDINAL AVE, Lumberton, NC 28360

Other Names 1

Other NameFull Potential At Pembroke

Other Identifiers 1

Medicaid6604094NC

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Community Based Residential Treatment Facility, Mental Illness
177 CARDINAL AVE
LUMBERTON, NC 28360

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Full Potential, LLC's NPI number?

The NPI number for Full Potential, LLC is 1083747828. It was assigned to this organization in the NPPES registry on March 13, 2007. The provider is also known as Full Potential At Pembroke.

Where is Full Potential, LLC located?

Full Potential, LLC is located at 177 Cardinal Ave, Lumberton, NC 28360. The listed phone number is (910) 670-1989.

What is Full Potential, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Full Potential, LLC was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.