Organization
EASON COURT GROUP HOME LLC #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONJA DENISE WILLIAMS (ASSISTANT DIRECTOR)
(571) 288-4144
Entity
Organization
Contact information
Practice address
124 GREGORY MNR, YOUNGSVILLE, NC 27596-9614
(919) 556-5355
(866) 285-8824
Mailing address
PO BOX 759, YOUNGSVILLE, NC 27596-0759
(919) 556-5355
(866) 285-8824
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL 035 029
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL 035 050
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804575
—
NC
Enumeration date
01/24/2017
Last updated
01/24/2017
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