Organization
IQUOLIOC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY L CLEVELAND (PRESIDENT)
(910) 355-2000
Entity
Organization
Contact information
Practice address
211 DRUMMER KELLUM RD, JACKSONVILLE, NC 28546-9308
(910) 355-2000
(910) 355-6900
Mailing address
211 DRUMMER KELLUM RD, JACKSONVILLE, NC 28546-9308
(910) 355-2000
(910) 355-6900
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-016-032
NC
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409548
—
NC
Enumeration date
02/28/2007
Last updated
10/03/2018
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