Organization
J-LO HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DANA ELAINE WILLIAMS B.A. (EXECUTIVE DIRECTOR)
(919) 222-2407
Entity
Organization
Contact information
Practice address
208 RANDALL LN, GOLDSBORO, NC 27534-8837
(919) 221-6719
(919) 734-4950
Mailing address
400 S PINEVIEW AVE, GOLDSBORO, NC 27530-6039
(919) 734-3924
(919) 734-4950
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-096-200
NC
Other
Enumeration date
07/11/2007
Last updated
07/11/2007
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