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Organization

CEDAR GROVE GROUP HOMES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. WANDA WILLIAMS JONES MHSA (DIRECTOR)
(919) 738-1765
Entity
Organization

Contact information

Practice address
140 COUNTRY RUN LN, GOLDSBORO, NC 27530-8901
(919) 738-1765
(919) 751-0089
Mailing address
PO BOX 1343, GOLDSBORO, NC 27533-1343
(919) 738-1765
(919) 751-0089

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
8300945
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3418140
NC
05
7804842
NC
05
7805605
NC
05
8300945
NC
Enumeration date
01/25/2007
Last updated
08/22/2020
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