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Organization
KEAIRA'S HOUSE ADULT GROUP HOME
Active
Organization
KEAIRA'S HOUSE ADULT GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH EVANS (OWNER)
(252) 446-8162
Entity
Organization
Contact information
Practice address
836 LINCOLN DR, ROCKY MOUNT, NC 27801-7456
(252) 446-8162
(252) 446-8162
Mailing address
2828 BERKLEY DR, ROCKY MOUNT, NC 27803-1312
(252) 446-8162
(252) 446-8162
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-033-067
NC
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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