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Organization
POTTERHOUSE SANCTUARY LIBERATION
Active
Organization
POTTERHOUSE SANCTUARY LIBERATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSA L MOORE (PRESIDENT)
(973) 223-4511
Entity
Organization
Contact information
Practice address
2805 AUBURN KNIGHTDALE RD, RALEIGH, NC 27610-9712
(919) 217-9119
(919) 217-9118
Mailing address
7344 BERKSHIRE DOWNS DR, RALEIGH, NC 27616-5636
(919) 217-9119
(919) 217-9118
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL029640
NC
Other
Enumeration date
01/05/2007
Last updated
06/12/2009
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