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Organization
EXCEL FOR LIFE (CEDAR HOME)
Active
Organization
EXCEL FOR LIFE (CEDAR HOME)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO JERMAINE JACKSON BACHELORS CRIMINAL (DIRECTOR)
(252) 205-0381
Entity
Organization
Contact information
Practice address
108 CEDAR CIR, WASHINGTON, NC 27889-9506
(252) 946-1432
Mailing address
108 CEDAR CIR, WASHINGTON, NC 27889-9506
(252) 946-1432
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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