in Goldsboro - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
- NPI 1871643700
is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Goldsboro, North Carolina. practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for is 1871643700. The last update date is .
's current location address is Po Box 10946, Goldsboro, North Carolina. You can contact this provider via phone number 9197781506 and fax number 9197781535. The mailing address for is Po Box 10946, Goldsboro, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | Po Box 10946, Goldsboro, North Carolina |
| Phone Number | 9197781506 |
| Fax Number | 9197781535 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1871643700 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | Po Box 10946 |
|---|---|
| City | Goldsboro |
| State | North Carolina (NC) |
| Post Code | 275320946 |
| Phone Number | 9197781506 |
| Fax Number | 9197781535 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | MHL-054-095 |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7806720 | NC | -- |
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