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Organization

LIVING WATERS GROUP HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BEVERLY ANN EALY (DIRECTOR)
(910) 717-6127
Entity
Organization

Contact information

Practice address
8383 CLIFFDALE RD, FAYETTEVILLE, NC 28314-5853
(910) 717-6127
(910) 339-1844
Mailing address
8383 CLIFFDALE RD, FAYETTEVILLE, NC 28314-5853
(910) 717-6127
(910) 339-1844

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
06/23/2009
Last updated
06/23/2009
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