Edwards Group Home 4
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Stantonsburg, NC
NPI 1609906288 · NPPES record last updated Jan 10, 2008
Key facts
- NPI
- 1609906288
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- License
- MHL040027 (NC)
- Legal business name
- EDWARDS GROUP HOME 4
- Practice address
- 1269 Apple Tree Rd
Stantonsburg, NC 27883-9039 - Phone
- (252) 747-4000
- Fax
- (252) 747-2602
- NPI assigned
- Mar 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Thomas McCollum
- Title
- Ceo
- Phone
- (252) 747-4000
National Provider Directory
Locations
1269 Apple Tree Rd
Stantonsburg, NC 27883
Phone (252) 747-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | MHL040027 | NC | Yes |
Addresses
Primary practice location
1269 Apple Tree Rd
Stantonsburg, NC 27883-9039
Mailing address
PO Box 295
Snow Hill, NC 28580-0295
Phone (252) 747-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7805335 | Other | NC | PROVIDER NUMBER |
Other providers in Stantonsburg, NC
- Carrie'S Family Care Home
- Circle of Love Family Care Home LLC.
- Easter Seals Ucp North Carolina & Virginia Inc.
- Edwards Group Home 3
- Melody Meeks Flannery
- Life, Inc.
- Stantonsburg Drug Company, Inc
- Stantonsburg Drug Company, Inc
- Virginia Dare Behavorial Health Services Inc.
All providers in Stantonsburg, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.