# PITT COUNTY GROUP HOME BOARD FOR MENTALLY RETARDED, AUTISTIC PERSONS,

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1922358241
- **Authorized official:** MARY GRACE BRIGHT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (252) 524-4950

## Contact information

- **Practice address:** 4263 N EDGE RD, AYDEN, NC 28513-7185
- **Practice address phone:** (252) 524-4950
- **Practice address fax:** (252) 524-3870
- **Mailing address:** PO BOX 9, GRIFTON, NC 28530-0009
- **Mailing address phone:** (252) 524-4950
- **Mailing address fax:** (252) 524-3870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-074-015 | NC | Yes |

## Other

- **Enumeration date:** 09/13/2012
- **Last updated:** 11/16/2012