Organization
MARY REBECCA'S VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA DANETTA GARRISON (ADMINISTRATOR)
(910) 527-4673
Entity
Organization
Contact information
Practice address
13605 US HIGHWAY 17 N, HAMPSTEAD, NC 28443-1945
(910) 319-0450
Mailing address
1887 SPIRALWOOD DR, FAYETTEVILLE, NC 28304-0499
(910) 527-4673
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-071-013
NC
Other
Enumeration date
04/08/2013
Last updated
04/09/2013
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