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Organization
MARTHA'S GROUP HOMES, INC
Active
Organization
MARTHA'S GROUP HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS TREVOUR SHEPARD MFA,QMHP (CEO)
(910) 938-0670
Entity
Organization
Contact information
Practice address
516 E SPRINGHILL TER, JACKSONVILLE, NC 28546-7366
(910) 938-0670
(910) 938-1229
Mailing address
516 E SPRINGHILL TER, JACKSONVILLE, NC 28546-7366
(910) 938-0670
(910) 938-1229
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PENDING
NC
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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