Organization
MACS VILLAGE LLC
Active
Other names
Macs Village LLC
Organization subpart
No
Provider details
NPI number
Authorized official
AMEKIA ANN THOMAS (DIRECTOR/ OWNER)
(336) 875-5636
Entity
Organization
Contact information
Practice address
205 PRINCETON XING, THOMASVILLE, NC 27360-9218
(336) 875-5636
Mailing address
PO BOX 3122, THOMASVILLE, NC 27361-3122
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MHL-029-142
—
NC
Enumeration date
04/16/2019
Last updated
05/08/2019
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