# RESIDENTIAL LOVING CARE GROUP HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760668198
- **Authorized official:** PATRICIA VINSON (CEO/PRESIDENT)
- **Authorized official phone:** (252) 539-1010

## Contact information

- **Practice address:** 2924 BRYANTOWN ROAD, 105 WEST MAIN STREET, AHOSKIE, NC 27910, JACKSON, NC 27845-0000
- **Practice address phone:** (252) 539-1010
- **Practice address fax:** (252) 539-2010
- **Mailing address:** PO BOX 681, WOODLAND, NC 27897-0681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NC | Yes |

## Other

- **Enumeration date:** 01/16/2008
- **Last updated:** 01/16/2008