Request For Information (Rfi) Form For Outpatient Opioid Treatment


Corporate Office:
514 East Main Street
Post Office Box 369
Beulaville, N.C. 28518
Administration: 800-513-4002
Access to Care: 800-913-6109
Kenneth E. Jones
Request for Information (RFI) Form for Outpatient Opioid Treatment
Provider Name that
your current
contract is in:
Contact Name:
Phone Number:
Email Address:
Do you currently
Yes: ____
operate a licensed
No: ____
Treatment Program
under 10A NCAC
27G .3600?
None: ____
Please list any
county(s) and
addresses where you
currently operate a
licensed Outpatient
Treatment Program
for Opioid
Treatment :
Managing Behavioral Healthcare for the Citizens of Bladen, Columbus, Duplin, Edgecombe, Greene, Lenoir, Nash, Robeson,
Sampson, Scotland, Wayne, and Wilson Counties
Website Address:
An Equal Opportunity/Affirmative Action Employer


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