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Organization

FOREVER YOUNG SECURED COMMUNITY

Active
Parent organization
FOREVER YOUNG GROUP CARE LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
FOREVER YOUNG GROUP CARE LLC
Authorized official
MRS. ALMA JEAN WESTON (ONWER)
(910) 527-0258
Entity
Organization

Contact information

Practice address
181 BOSTIC RD, RAEFORD, NC 28376-6101
(910) 527-0258
(910) 864-2548
Mailing address
1133 CHESTNUT WOOD DR, FAYETTEVILLE, NC 28314-1890
(910) 527-0258
(910) 864-2548

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL047101
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6604011
NC
Enumeration date
02/01/2007
Last updated
04/08/2013
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