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Organization
GREATER IMAGE HEALTHCARE CORP
Active
Organization
GREATER IMAGE HEALTHCARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY L JOHNSON (CEO)
(910) 321-0069
Entity
Organization
Contact information
Practice address
114 GREENHOUSE LN, SOUTHERN PINES, NC 28387-3140
(910) 246-2272
Mailing address
401 ROBESON ST, FAYETTEVILLE, NC 28301-5635
(910) 321-0069
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-063-104
NC
Other
Enumeration date
10/22/2013
Last updated
05/11/2017
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