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Organization
EVANGELISTIC DELIVERANCE CENTER ADULT GROUP HOME
Active
Organization
EVANGELISTIC DELIVERANCE CENTER ADULT GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA WILLIAMS DICKENS (OWNER/OPERATOR/ADMINISTRATOR)
(252) 823-3699
Entity
Organization
Contact information
Practice address
1302 SAINT ANDREW ST, TARBORO, NC 27886-3032
(252) 823-3699
(252) 641-1681
Mailing address
1302 SAINT ANDREW ST, TARBORO, NC 27886-3032
(252) 823-3699
(252) 641-1681
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
10/07/2007
Last updated
10/07/2007
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