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Organization
TRINITY WILL GROUP
Active
Organization
TRINITY WILL GROUP
Active
Other names
Jireh Haven
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY MELINDA WILLIAMS (EXECUTIVE DIRECTOR)
(910) 525-5035
Entity
Organization
Contact information
Practice address
140 FAULKNER LN, ROSEBORO, NC 28382-5415
(910) 525-5035
(910) 525-5065
Mailing address
PO BOX 618, CLINTON, NC 28329-0618
(910) 590-2971
(910) 596-2971
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL082046
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603564
—
NC
Enumeration date
10/24/2006
Last updated
01/02/2008
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