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Individual
MR. BOBBY EATMON
Active
Individual
MR. BOBBY EATMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL039034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040968
FACILITY ID
NC
Enumeration date
02/27/2007
Last updated
07/08/2007
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