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Organization
MUTTY GROUP HOME
Active
Organization
MUTTY GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUTIAT B BAMGBALA (OWNER)
(860) 986-0003
Entity
Organization
Contact information
Practice address
254 ASHFIELD LN, LEXINGTON, NC 27292-8348
(860) 986-0003
Mailing address
254 ASHFIELD LN, LEXINGTON, NC 27292-8348
(860) 986-0003
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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