Organization
PEOPLE OF POTENTIAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN L MCCULLEN (DIRECTOR)
(910) 265-1756
Entity
Organization
Contact information
Practice address
113 COURTLAND DR, JACKSONVILLE, NC 28546-6017
(910) 265-1756
(910) 265-1756
Mailing address
113 COURTLAND DR, JACKSONVILLE, NC 28546-6017
(910) 265-1756
(910) 265-1756
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NC
251S00000X
Community/Behavioral Health Agency
—
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409608
—
NC
05
—
8301274
—
NC
Enumeration date
08/18/2006
Last updated
11/21/2012
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