Organization
GREATER IMAGE HEALTHCARE, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY JOHNSON (CEO)
(910) 321-0069
Entity
Organization
Contact information
Practice address
401 ROBERSON STREET, FAYETTEVILLE, NC 28301-5423
(910) 321-0069
(910) 491-1000
Mailing address
401 ROBERSON STREET, FAYETTEVILLE, NC 28301-5423
(910) 321-0069
(910) 491-1000
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457481988
—
NC
05
—
1508996059
—
NC
05
—
5919267
—
NC
05
—
6008694
—
NC
05
—
8302847
—
NC
Enumeration date
04/09/2009
Last updated
07/15/2020
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