Organization
MARY TAYLOR HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLENE GAGE RN (EXECUTIVE DIRECTOR)
(252) 566-8455
Entity
Organization
Contact information
Practice address
6957 NC HIGHWAY 903 S, LA GRANGE, NC 28551-8367
(252) 566-8455
(252) 566-8455
Mailing address
6957 NC HIGHWAY 903 S, LA GRANGE, NC 28551-8367
(252) 566-8455
(252) 566-8455
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
MHL-040-036
NC
251C00000X
Developmentally Disabled Services Day Training Agency
MHL-040-036
NC
261QA0005X
Ambulatory Family Planning Facility
MHL-040-036
NC
3104A0625X
Assisted Living Facility (Mental Illness)
MHL-040-036
NC
311Z00000X
Custodial Care Facility
MHL-040-036
NC
315P00000X
Intellectual Disabilities Intermediate Care Facility
MHL-040-036
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-040-036
NC
320700000X
Physical Disabilities Residential Treatment Facility
MHL-040-036
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-040-036
NC
332900000X
Non-Pharmacy Dispensing Site
MHL-040-036
NC
3336L0003X
Long Term Care Pharmacy
MHL-040-036
NC
343900000X
Non-emergency Medical Transport (VAN)
MHL-040-036
NC
347C00000X
Private Vehicle
MHL-040-036
NC
385H00000X
Respite Care
MHL-040-036
NC
Other
Enumeration date
03/02/2007
Last updated
09/01/2007
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