Organization
WAYNE COUNTY FAMILY LIFE RESIDENTIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH C. WILLIAMS RN-081918 (RN- DIRECTOR)
(919) 736-9605
Entity
Organization
Contact information
Practice address
514 FOREST HILL DR., GOLDSBORO, NC 27533-0296
(919) 736-9605
Mailing address
200 PERRY DR., GOLDSBORO, NC 27530
(919) 734-0617
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-096-177
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHL-096-177
1300- LEVEL II GROUP HOME
NC
Enumeration date
09/19/2006
Last updated
08/22/2020
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