Organization
AGAPE II GHSD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HYESON KIM REED PROGRAM MANAGER (CEO)
(910) 980-1085
Entity
Organization
Contact information
Practice address
166 PHILLIPS RD, DUNN, NC 28334-1382
(910) 567-2869
(910) 980-1768
Mailing address
7279 SMITHFIELD RD, GODWIN, NC 28344-8315
(910) 980-1085
(910) 980-1768
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-082-070
NC
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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