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Organization
LIVING WATERS GROUP HOME #2
Active
Organization
LIVING WATERS GROUP HOME #2
Active
Parent organization
LIVING WATER GROUP HOME #2
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVING WATER GROUP HOME #2
Authorized official
BEVERLY ANN EALY (DIRECTOR)
(910) 717-6127
Entity
Organization
Contact information
Practice address
1264 DAVIS BRIDGE RD, PARKTON, NC 28371-9621
(910) 858-1403
(910) 339-1844
Mailing address
8419 CARTMAN DR, FAYETTEVILLE, NC 28314-8419
(910) 717-6127
(910) 339-1844
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-078-219
NC
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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