Edwards Group Home 3

Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Stantonsburg, NC

NPI 1245360387 · NPPES record last updated Jan 10, 2008

Key facts

NPI
1245360387
Entity type
Organization (NPI type 2)
Primary specialty
Mental Illness Community Based Residential Treatment Facility 320800000X
License
MHL040026 (NC)
Legal business name
EDWARDS GROUP HOME 3
Practice address
1233 Appletree Road
Stantonsburg, NC 27833
Phone
(252) 747-4000
Fax
(252) 747-2602
NPI assigned
Mar 7, 2007
Organization subpart
No

Authorized official

Name
Thomas McCollum
Title
Ceo
Phone
(252) 747-4000

National Provider Directory

Locations

1233 Apple Tree Rd
Stantonsburg, NC 27883
Phone (252) 747-4000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL040026 NC Yes

Addresses

Primary practice location

1233 Appletree Road
Stantonsburg, NC 27833

Mailing address

PO Box 295
Snow Hill, NC 28580-0295
Phone (252) 747-4000

Other identifiers

IdentifierTypeStateIssuer
7805043OtherNCPROVIDER NUMBER

Other providers in Stantonsburg, NC

All providers in Stantonsburg, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.