Organization
MY FRIEND'S HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONNIE BUTTERFIELD (OWNER/MEMBER)
(252) 206-7408
Entity
Organization
Contact information
Practice address
3607 COLUMBIA AVENUE, WILSON, NC 27896
(252) 206-7408
(312) 324-0677
Mailing address
3607 COLUMBIA AVENUE, WILSON, NC 27896
(252) 206-7408
(312) 324-0677
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
02/26/2009
Last updated
02/26/2009
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