Organization
SUPPORT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILSON EGBE TABE MD (OWNNER)
(919) 735-3311
Entity
Organization
Contact information
Practice address
1402 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2252
(919) 735-3311
(919) 735-1568
Mailing address
1216 NORTH DR, GOLDSBORO, NC 27534-1858
(919) 734-4420
(919) 735-1568
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MHL-096-193
NC
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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