Organization
SHILOH CHILD AND ADOLESCENT DAY TREATMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY PLUMMER BROWN (OWNER)
(252) 443-3045
Entity
Organization
Contact information
Practice address
312 S FRANKLIN ST, ROCKY MOUNT, NC 27804-5711
(252) 443-3045
(252) 443-2755
Mailing address
312 S FRANKLIN ST, ROCKY MOUNT, NC 27804-5711
(252) 443-3045
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
MHL-064111
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHL-111
STATE OF NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES
NC
Enumeration date
03/29/2010
Last updated
03/29/2010
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